OBJECTIVE: There is emerging evidence that the pancreas may be a target organ of SARS-CoV-2 infection . This aim of this study was to investigate the outcome of patients with acute pancreatitis (AP) and coexistent SARS-CoV-2 infection .

DESIGN: A prospective international multicentre cohort study including consecutive patients admitted with AP during the current pandemic was undertaken . Primary outcome measure was severity of AP . Secondary outcome measures were aetiology of AP, intensive care unit (ICU) admission, length of hospital stay, local complications, acute respiratory distress syndrome (ARDS), persistent organ failure and 30-day mortality . Multilevel logistic regression was used to compare the two groups .

RESULTS: 1777 patients with AP were included during the study period from 1 March to 23 July 2020 . 149 patients (8.3 %) had concomitant SARS-CoV-2 infection . Overall, SARS-CoV-2-positive patients were older male patients and more likely to develop severe AP and ARDS (p <0.001). Unadjusted analysis showed that SARS-CoV-2-positive patients with AP were more likely to require ICU admission (OR 5.21, p <0.001), local complications (OR 2.91, p <0.001), persistent organ failure (OR 7.32, p <0.001), prolonged hospital stay (OR 1.89, p <0.001) and a higher 30-day mortality (OR 6.56, p <0.001). Adjusted analysis showed length of stay (OR 1.32, p <0.001), persistent organ failure (OR 2.77, p <0.003) and 30-day mortality (OR 2.41, p <0.04) were significantly higher in SARS-CoV-2 co-infection .

CONCLUSION: Patients with AP and coexistent SARS-CoV-2 infection are at increased risk of severe AP, worse clinical outcomes, prolonged length of hospital stay and high 30-day mortality.