Occam’s razor or Hickam’s dictum-COVID-19 is not a textbook aetiology of acute pancreatitis:A modified Naranjo Score appraisal  

作　　者：Thomas Zheng Jie Teng Branden Qi Yu Chua Puay Khim Lim Kai Siang Chan Vishal G Shelat 

机构地区：[1]Lee Kong Chian School of Medicine,Nanyang Technological University,Singapore 308232,Singapore [2]Department of General Surgery,Tan Tock Seng Hospital,Singapore 308433,Singapore [3]Surgical Science Training Centre,Tan Tock Seng Hospital,Singapore 308433,Singapore

出　　处：《World Journal of Gastroenterology》2023年第13期2050-2063,共14页世界胃肠病学杂志（英文版）

摘　　要：BACKGROUND Acute pancreatitis(AP)is a disease spectrum ranging from mild to severe disease.During the coronavirus disease 2019(COVID-19)pandemic,numerous reports of AP have been published,with most authors concluding a causal relationship between COVID-19 and AP.Retrospective case reports or small case series are unable to accurately determine the cause-effect relationship between COVID-19 and AP.AIM To establish whether COVID-19 is a cause of AP using the modified Naranjo scoring system.METHODS A systematic review was conducted on PubMed,World of Science and Embase for articles reporting COVID-19 and AP from inception to August 2021.Exclusion criteria were cases of AP which were not reported to be due to COVID-19 infection,age<18 years old,review articles and retrospective cohort studies.The original 10-item Naranjo scoring system(total score 13)was devised to approximate the likelihood of a clinical presentation to be secondary to an adverse drug reaction.We modified the original scoring system into a 8-item modified Naranjo scoring system(total score 9)to determine the cause-effect relationship between COVID-19 and AP.A cumulative score was decided for each case presented in the included articles.Interpretation of the modified Naranjo scoring system is as follows:≤3:Doubtful,4-6:Possible,≥7:Probable cause.RESULTS The initial search resulted in 909 articles,with 740 articles after removal of duplicates.A total of 67 articles were included in the final analysis,with 76 patients which had AP reported to be due to COVID-19.The mean age was 47.8(range 18-94)years.Majority of patients(73.3%)had≤7 d between onset of COVID-19 infection and diagnosis of AP.There were only 45(59.2%)patients who had adequate investigations to rule out common aetiologies(gallstones,choledocholithiasis,alcohol,hypertriglyceridemia,hypercalcemia and trauma)of AP.Immunoglobulin G4 testing was conducted in 9(13.5%)patients to rule out autoimmune AP.Only 5(6.6%)patients underwent endoscopic ultrasound and/or magnetic resonance cholangiop

关 键 词：COVID-19 INFECTIONS Pancreatic diseases PANCREATITIS Post-acute COVID-19 syndrome 

分 类 号：R576[医药卫生—消化系统]