2019冠状病毒病对急性胰腺炎临床结果的影响：日本一项全国性观察性研究

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology Pub Date : 2025-09-01 DOI:10.1016/j.pan.2025.08.010

Tomoo Manaka , Kunio Tarasawa , Tetsuya Takikawa , Kazuhiro Kikuta , Ryotaro Matsumoto , Yu Tanaka , Takanori Sano , Shin Hamada , Shin Miura , Kiyoshi Kume , Kenji Fujimori , Kiyohide Fushimi , Atsushi Masamune

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引用次数: 0

摘要

背景/目的：急性胰腺炎（AP）是一种全球发病率不断上升的主要胃肠道疾病。然而，2019年冠状病毒病（COVID-19）对AP的影响尚不清楚，特别是在日本。本研究旨在利用日本全国行政数据库调查AP与COVID-19之间的关系，包括合并症的影响。方法：回顾性分析在诊断程序组合数据库中登记的2020年4月至2023年3月期间住院的AP患者。将患者分为covid -19阴性组和covid -19阳性组。结果：在65,770例AP患者中，548例（0.8%）为COVID-19阳性，其中345例患者在入院时记录为合并症，203例患者在住院期间记录为次要诊断。与covid -19阴性组相比，covid -19阳性组的严重AP比例（42.0%比30.2%）、重症监护病房入院率（4.6%比2.7%）、机械通气（5.5%比2.5%）、局部并发症干预（3.3%比1.8%）和住院死亡率（5.0%比2.5%）更高。倾向评分匹配后，COVID-19阳性和肾脏疾病与严重AP相关。按COVID-19诊断时间分层时，与未诊断COVID-19或入院时诊断的患者相比，住院期间诊断的患者年龄更大，住院时间更长，住院死亡率更高。结论：合并COVID-19感染的患者，特别是在住院期间确诊的患者，与未感染COVID-19的患者相比，严重AP和住院死亡率的风险增加。

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Impact of coronavirus disease 2019 on the clinical outcomes of acute pancreatitis: a nationwide observational study in Japan

Background/objectives

Acute pancreatitis (AP) is a major gastrointestinal disorder with an increasing global incidence. However, the impact of coronavirus disease 2019 (COVID-19) on AP remains unclear, particularly in Japan. This study aimed to investigate the association between AP and COVID-19, including the influence of comorbidities, using a Japanese nationwide administrative database.

Methods

We retrospectively analyzed patients with AP who were hospitalized between April 2020 and March 2023, registered in the Diagnosis Procedure Combination database. Patients were classified into COVID-19-negative and COVID-19-positive groups. Propensity score matching was performed to adjust for potential confounders in the analysis of factors associated with severe AP.

Results

Among 65,770 patients with AP, 548 (0.8 %) were COVID-19-positive, with COVID-19 recorded as a comorbidity at admission in 345 patients and as a secondary diagnosis during hospitalization in 203 patients. Compared with the COVID-19-negative group, the COVID-19-positive group had a higher proportion of severe AP (42.0 % vs. 30.2 %), intensive care unit admissions (4.6 % vs. 2.7 %), mechanical ventilation (5.5 % vs. 2.5 %), interventions for local complications (3.3 % vs. 1.8 %), and in-hospital mortality (5.0 % vs. 2.5 %). After propensity score matching, COVID-19 positivity and renal disease were associated with severe AP. When stratified by the timing of COVID-19 diagnosis, patients diagnosed during hospitalization were older, had longer hospital stays, and experienced higher in-hospital mortality compared with those without COVID-19 or those diagnosed at admission.

Conclusions

Patients with concurrent COVID-19 infection, particularly those diagnosed during hospitalization, are at increased risk of severe AP and in-hospital mortality compared to those without COVID-19.

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来源期刊

Pancreatology 医学-胃肠肝病学

CiteScore

7.20

自引率

5.60%

发文量

194

审稿时长

44 days

期刊介绍： Pancreatology is the official journal of the International Association of Pancreatology (IAP), the European Pancreatic Club (EPC) and several national societies and study groups around the world. Dedicated to the understanding and treatment of exocrine as well as endocrine pancreatic disease, this multidisciplinary periodical publishes original basic, translational and clinical pancreatic research from a range of fields including gastroenterology, oncology, surgery, pharmacology, cellular and molecular biology as well as endocrinology, immunology and epidemiology. Readers can expect to gain new insights into pancreatic physiology and into the pathogenesis, diagnosis, therapeutic approaches and prognosis of pancreatic diseases. The journal features original articles, case reports, consensus guidelines and topical, cutting edge reviews, thus representing a source of valuable, novel information for clinical and basic researchers alike.