P0050 - The Impact of Chronic Pancreatitis on Outcomes of Patients with COVID-19: A Propensity-Matched Cohort Study

Sunday, October 22, 2023

3:30 PM – 7:00 PM PT

Location: Exhibit Hall

Presenting Author(s)

Khaled Alsabbagh Alchirazi, MD

Cleveland Clinic
Cleveland, OH

Khaled Alsabbagh Alchirazi, MD¹, Vibhu Chittajallu, MD², Sushrut Trakroo, MD³, Nour Azzouz, MD¹, Osama Hamid, MD, MRCPI¹, Jaime A. Perez, PhD⁴, Prabhleen Chahal, MD⁵
¹Cleveland Clinic, Cleveland, OH; ²Case Western Reserve University / University Hospitals, Cleveland, OH; ³Cleveland Clinic, Strongsville, OH; ⁴University Hospitals Clinical Research Center, Cleveland, OH; ⁵Cleveland Clinic Foundation, Cleveland, OH

Introduction: Coronavirus disease 2019 (COVID-19) has been a global pandemic. COVID-19 primarily affects the lungs; however, several studies have reported an association between COVID-19 and acute pancreatitis (AP), with some studies reporting an increase in severity of pancreatitis with an adverse impact on morbidity and mortality in patients with COVID-19 and AP. However, the data regarding outcomes of COVID-19 in patients with a history of chronic pancreatitis (CP) is lacking. In our study we aim to investigate COVID-19 related outcomes in CP patients.

Methods: We used a large national healthcare research network, including over 106 million patients, sourced from 73 health care organizations located within the United State (US) (TriNetX, a global federated health research network exempts from IRB) and identified all adult patients (aged ≥ 18 years) with COVID-19 infection between January 1, 2020 to January 1, 2023. We compared several COVID-19 related complications in patients with and without CP. 1:1 propensity-score matching was performed for age, gender, race, ethnicity, and all major risk factors of COVID-19 among all cohorts. We assessed COVID-19 outcomes up to 3 months of index date (COVID-19 diagnosis). Adjusted odds ratios (aOR) with 95% confidence interval (CI) were calculated.

Results: General demographics before and after propensity score matching described in table 1. After propensity score matching, thirty-day outcomes showed a significant increase in shock, gastrointestinal hemorrhage, acute respiratory distress syndrome, myocardial ischemia, and increased rate of hospitalization. There was no significant increase in mortality (P= 0.071), Figure 1, panel A. Regarding all-time outcomes data, there was again a significant difference in presence of shock, gastrointestinal hemorrhage, acute respiratory distress syndrome, myocardial ischemia, and increased rate of hospitalization in patients with COVID-19 and CP versus no CP patients. There was also a significant increase in mortality in CP group as compared to patients with COVID-19 and no CP. Figure 1, panel B.

Discussion: Our study is the largest to date to investigate COVID-19 related outcomes in CP patient. We found that CP patients infected with COVID-19 have significantly worse COVID-19 related outcomes compared with COVID-19 patients without CP. Further studies are needed to better understand the exact relationship between COVID-19 and CP.

Figure: Figure 1. Outcomes between chronic pancreatitis (CP) and non-chronic pancreatitis (No CP) patients with a positive COVID-19 infection, after propensity score matching. panel A: 30-day outcomes of COVID-19 infection, Panel B: All-time outcomes after COVID-19 infection. VTE; Venous thromboembolism, MI; myocardial infarction, AKI; acute kidney injury, ARDS; acute respiratory distress syndrome, cardiac complications; myocarditis, pericarditis and arrhythmias.

	Before Matching			After Matching
Characteristic Name	CP	No CP	p-Value	CP	No CP	p-Value
n	10205	3205696		10205	10205
Age	57.67 ± 15.99	47.51 ± 17.79	0	57.67 ± 15.99	57.53 ± 16.47	0.524214
At least 65 years	3699 (36.2%)	644103 (20.1%)	0	3699 (36.2%)	3758 (36.8%)	0.39109
Not Hispanic or Latino	8103 (79.4%)	1789391 (55.8%)	0	8103 (79.4%)	8146 (79.8%)	0.455004
White	7055 (69.1%)	1723000 (53.7%)	0	7055 (69.1%)	7118 (69.8%)	0.338421
Female	5396 (52.9%)	1836763 (57.3%)	1.99E-19	5396 (52.9%)	5373 (52.7%)	0.74709
Male	4809 (47.1%)	1367848 (42.7%)	1.05E-19	4809 (47.1%)	4831 (47.3%)	0.757733
Black or African American	1941 (19.0%)	461548 (14.4%)	3.27E-40	1941 (19.0%)	1914 (18.8%)	0.629205
Unknown Ethnicity	1283 (12.6%)	1162761 (36.3%)	0	1283 (12.6%)	1243 (12.2%)	0.395202
Unknown Race	1006 (9.9%)	943059 (29.4%)	0	1006 (9.9%)	974 (9.5%)	0.449175
Hispanic or Latino	819 (8.0%)	253544 (7.9%)	0.663819	819 (8.0%)	816 (8.0%)	0.93834
Asian	125 (1.2%)	61591 (1.9%)	3.06E-07	125 (1.2%)	145 (1.4%)	0.220465
American Indian or Alaska Native	70 (0.7%)	11782 (0.4%)	1.16E-07	70 (0.7%)	46 (0.5%)	0.025437
Native Hawaiian or Other Pacific Islander	10 (0.1%)	4716 (0.1%)	0.19589	10 (0.1%)	10 (0.1%)	1
Unknown Gender	0 (0.0%)	1085 (0.0%)	0.063055	0 (0.0%)	10 (0.1%)	0.001561
Essential (primary) hypertension	7357 (72.1%)	782538 (24.4%)	0	7357 (72.1%)	7404 (72.6%)	0.462145
Disorders of lipoprotein metabolism and other lipidemias	6219 (60.9%)	712037 (22.2%)	0	6219 (60.9%)	6240 (61.1%)	0.763086
Type 2 diabetes mellitus	5334 (52.3%)	396842 (12.4%)	0	5334 (52.3%)	5359 (52.5%)	0.72605
Overweight and obesity	3999 (39.2%)	528991 (16.5%)	0	3999 (39.2%)	4027 (39.5%)	0.688247
Nicotine dependence	3982 (39.0%)	326964 (10.2%)	0	3982 (39.0%)	3993 (39.1%)	0.874609
Personal history of nicotine dependence	3785 (37.1%)	307271 (9.6%)	0	3785 (37.1%)	3810 (37.3%)	0.717334
Asthma	2769 (27.1%)	312714 (9.8%)	0	2769 (27.1%)	2757 (27.0%)	0.850067
Alcohol related disorders	2767 (27.1%)	102174 (3.2%)	0	2767 (27.1%)	2721 (26.7%)	0.467714
Other chronic obstructive pulmonary disease	2567 (25.2%)	137365 (4.3%)	0	2567 (25.2%)	2539 (24.9%)	0.650895
Body mass index [BMI] 30-39, adult	2148 (21.0%)	246493 (7.7%)	0	2148 (21.0%)	2148 (21.0%)	1
Body mass index [BMI] 40 or greater, adult	922 (9.0%)	133359 (4.2%)	0	922 (9.0%)	920 (9.0%)	0.961034
Hypertensive crisis	633 (6.2%)	26078 (0.8%)	0	633 (6.2%)	609 (6.0%)	0.482229
Secondary hypertension	568 (5.6%)	28806 (0.9%)	0	568 (5.6%)	523 (5.1%)	0.161416
Unspecified maternal hypertension	78 (0.8%)	18809 (0.6%)	0.019068	78 (0.8%)	99 (1.0%)	0.112888
Unspecified pre-existing hypertension complicating pregnancy, childbirth and the puerperium	64 (0.6%)	11887 (0.4%)	2.15E-05	64 (0.6%)	55 (0.5%)	0.407985
Pre-existing essential hypertension complicating pregnancy, childbirth and the puerperium	51 (0.5%)	10309 (0.3%)	0.001518	51 (0.5%)	46 (0.5%)	0.610834
Pre-existing hypertension with pre-eclampsia	33 (0.3%)	3719 (0.1%)	8.98E-10	33 (0.3%)	24 (0.2%)	0.232577
Pre-existing secondary hypertension complicating pregnancy, childbirth and the puerperium	10 (0.1%)	367 (0.0%)	7.49E-16	10 (0.1%)	10 (0.1%)	1
COVID-19 Vaccination (CPT codes)
91300	782 (7.7%)	124384 (3.9%)	0	782 (7.7%)	782 (7.7%)	1
91301	177 (1.7%)	26961 (0.8%)	6.8E-23	177 (1.7%)	191 (1.9%)	0.461445
91305	78 (0.8%)	8100 (0.3%)	1.23E-24	78 (0.8%)	68 (0.7%)	0.40621
91306	49 (0.5%)	10226 (0.3%)	0.003973	49 (0.5%)	44 (0.4%)	0.6033
91303	23 (0.2%)	2616 (0.1%)	4.1E-07	23 (0.2%)	20 (0.2%)	0.646968
91312	14 (0.1%)	1691 (0.1%)	0.000216	14 (0.1%)	11 (0.1%)	0.548261
91313	10 (0.1%)	321 (0.0%)	2.19E-18	10 (0.1%)	10 (0.1%)	1
91302	0 (0.0%)	0 (0.0%)		0 (0.0%)	0 (0.0%)
91304	0 (0.0%)	0 (0.0%)		0 (0.0%)	0 (0.0%)
91307	0 (0.0%)	10 (0.0%)	0.858392	0 (0.0%)	0 (0.0%)
91308	0 (0.0%)	0 (0.0%)		0 (0.0%)	0 (0.0%)
91309	0 (0.0%)	34 (0.0%)	0.742161	0 (0.0%)	0 (0.0%)
91310	0 (0.0%)	0 (0.0%)		0 (0.0%)	0 (0.0%)
91311	0 (0.0%)	10 (0.0%)	0.858392	0 (0.0%)	0 (0.0%)
91314	0 (0.0%)	0 (0.0%)		0 (0.0%)	0 (0.0%)
91315	0 (0.0%)	10 (0.0%)	0.858392	0 (0.0%)	0 (0.0%)
91316	0 (0.0%)	0 (0.0%)		0 (0.0%)	0 (0.0%)
91317	0 (0.0%)	0 (0.0%)		0 (0.0%)	0 (0.0%)

Table: Table 1: Baseline characteristics between chronic pancreatitis (CP) and non-chronic pancreatitis (No CP) patients with a positive COVID-19 infection, before and after propensity score matching.

Disclosures:

Khaled Alsabbagh Alchirazi indicated no relevant financial relationships.

Vibhu Chittajallu indicated no relevant financial relationships.

Sushrut Trakroo indicated no relevant financial relationships.

Nour Azzouz indicated no relevant financial relationships.

Osama Hamid indicated no relevant financial relationships.

Jaime Perez indicated no relevant financial relationships.

Prabhleen Chahal indicated no relevant financial relationships.

Khaled Alsabbagh Alchirazi, MD¹, Vibhu Chittajallu, MD², Sushrut Trakroo, MD³, Nour Azzouz, MD¹, Osama Hamid, MD, MRCPI¹, Jaime A. Perez, PhD⁴, Prabhleen Chahal, MD⁵. P0050 - The Impact of Chronic Pancreatitis on Outcomes of Patients with COVID-19: A Propensity-Matched Cohort Study, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.