Ariel Blog Considerations for Pancreatitis Patients During the COVID-19 Pandemic

Considerations for Pancreatitis Patients During the COVID-19 Pandemic

Katya Orlova  |  Published March 30, 2020

The novel coronavirus is currently causing a pandemic around the world. New research emerges daily about the virus and the disease it causes, called COVID-19.

Who is at risk for COVID-19?

Scientists predict that 40-70% of the world population will be infected with the new coronavirus over the coming year. Although many people will have mild disease, or be infected and have no symptoms, individuals in certain groups are at higher risk for severe illness due to COVID-19.

The risk for severe illness increases with age, especially for those 65 and older, however the median age of hospitalized people is 49 to 56. Others at risk for severe illness are people with certain pre-existing conditions such as high blood pressure, heart disease, diabetes, lung disease, those with impaired immune systems, those affected by obesity, and potentially others.

Are pancreatitis patients at increased risk for more severe disease?

No scientific research studies have yet been published on pancreatitis and risk for infection or more severe COVID-19 illness. However, depending on the reason for pancreatitis, some patients may have increased risk for more severe COVID-19 and are recommended to stay home and take precautions as if they are in the higher risk group.

Individuals with pancreatitis as a result of cystic fibrosis may be at increased risk for more severe COVID-19, however risk for individuals may vary based on factors such as the presence of lung disease. The Cystic Fibrosis Foundation has FAQs regarding COVID-19 for people with CF. Individuals with autoimmune causes of pancreatitis may be treated with steroid therapy, which depresses the immune system, and may thus increase risk for more severe COVID-19.

Several health issues that can occur with pancreatitis are known to place people at higher risk for more severe illness. Individuals with pancreatitis are more likely to have diabetes, which increases risk for severe COVID-19. Therefore, it may be even more important to keep diabetes well controlled. Having had recent surgery, including for pancreatitis, may also make a person more vulnerable to infection. Finally, individuals with pancreatitis have an increased risk of pancreatic cancer. Pancreatic cancer may put patients at increased risk of severe COVID-19 due to having a weakened immune system because of the cancer or cancer treatments.

Regardless of the cause of pancreatitis, your healthcare providers are the best resource for questions regarding the potential impact of the new coronavirus.

Behaviors that increase risk for severe COVID-19

If a person with pancreatitis smokes or uses tobacco, they are likely to be more vulnerable to COVID-19 due to potential lung disease or reduced lung capacity. Smoking may also promote transmission of virus from hand to mouth, or within communal settings due to sharing of water pipes or cigarettes. Excessive alcohol consumption may also put patients at increased risk for severe COVID-19. Excess alcohol lowers immunity and renders people more susceptible to pneumonia and other respiratory issues.

People who smoke marijuana or vape may also be at an increased risk because the coronavirus attacks the lungs. Individuals with opioid use disorder (OUD) and methamphetamine use disorder are potentially also more vulnerable to COVID-19 because of the effects of the drugs on breathing and the health of the lungs.

Digestive symptoms of COVID-19

Scientists are increasingly recognizing that gastrointestinal symptoms are common in COVID-19 patients, and individuals with pancreatitis should be aware that there may be overlap between their digestive symptoms and those of COVID-19.

Approximately half of patients coming to the hospital for COVID-19 have digestive symptoms, based on a preliminary study of Chinese hospitals. The digestive symptoms of 204 patients included lack of appetite (78.6%), diarrhea (34%), vomiting (3.9%), and abdominal pain (1.9%). Individuals with digestive symptoms also had a longer time from symptom onset to admission than those without digestive symptoms, and the digestive symptoms tended to get more pronounced over time. 3% of patients had digestive symptoms without the respiratory symptoms classic to COVID-19.

There  is also preliminary evidence that due to COVID-19, there could be changes in a person’s ability to smell and taste, even without other symptoms. Infected individuals can experience a diminished or absent sense of smell, or a lack of taste. These symptoms are used by some doctors during screening for COVID-19, especially if they occur without hay fever or sinus infection.

How it’s spread

The virus is spread through close person-to-person contact among people who are within 6 feet of one another. The main way the virus spreads is through tiny droplets in the air produced when an infected person coughs, sneezes or talks. These droplets can be inhaled by people, or drop on the mouths or noses of people, and cause infection.

The virus may also spread when a person touches a surface or object that has virus on it, possibly from the touch or cough of an infected person. If the novel coronavirus ends up on a surface, it can live for days. The virus can remain on plastic and stainless steel for up to 3 days, on cardboard for 24 hours, and on copper for 4 hours.

The virus has also been found in the stool of some people diagnosed with COVID-19, however the chances of getting infected due to contact with stool is not yet known.

How to prevent infection

The Centers for Disease Control and Prevention (CDC) has released guidance on how to prevent infection, and what to do if you think you are sick, including when to get medical attention for emergency warning signs. Those at higher risk for severe COVID-19, including those with severe underlying medical conditions, are recommended to stay home, if possible.

Obtain necessary medications and supplies

If there is a COVID-19 outbreak in your region you may need to stay home for a prolonged period of time. You may also need to stay isolated at home if you come down with COVID-19.

To best prepare for these scenarios, the CDC recommends asking your healthcare provider to obtain extra medications. Consider also obtaining other over-the-counter medications for treating fever or other symptoms of COVID at home, and some extra groceries and household items.

Mutual Aid

Whether you are in the higher risk groups or not, consider joining a local Mutual Aid group. These groups help vulnerable people avoid going to crowded places for essentials and provide other help. For example, people can get help grocery shopping or picking up prescriptions, share needed supplies, check in on elderly neighbors, obtain information about financial relief and much more. Mutual Aid groups in your city are likely available via the neighborhood social media network Nextdoor, on Facebook, and through local community organizations. Some organizations administer “buddy systems” that pair vulnerable people with volunteers to help share information and with basic tasks.

Stay informed about COVID-19 in your community and state

Visit your state department of health website and local county website for information about COVID-19 in your state. You may be able to sign up for email or phone-based alerts from your county about COVID-19 and government guidance, such as shelter-in-place orders and school closures. For national guidance, including informational and instructional guides, visit the CDC’s COVID-19 website.

Mental health

It is normal to have a variety of reactions to the uncertainties and societal changes that are occurring due to the pandemic. There are a number of things you can do to cope with any anxiety or stress. Staying connected virtually with other people with pancreatitis through patient support forums or other social media can ward off loneliness and provide access to helpful information.

Need help, or know someone who does?

Substance Abuse and Mental Health Disaster Distress Helpline

  • 1-800-985-5990 (TTY 1-800-846-8517)
  • Or text TalkWithUs to 66746

National Domestic Violence Hotline 1-800-799-7233

If you want to harm yourself or others call 911

 

References

Amodeo G, Bugada D, Franchi S, et al. Immune function after major surgical interventions: the effect of postoperative pain treatment. J Pain Res. 2018;11:1297-1305.

Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020; 395:507.

Coronavirus (COVID-19). Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-nCoV/index.html

Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395:497.

Pan L, Mu M, Yang P, et al. Clinical characteristics of COVID-19 patients with digestive symptoms in Hubei, China: a descriptive, cross-sectional, multicenter study. https://journals.lww.com/ajg/Documents/COVID_Digestive_Symptoms_AJG_Preproof.pdf? Am J Gastro. 2020.

Salo M. Effects of anesthesia and surgery on the immune response. Acta Anaesthesiol Scand. 1992;36(3):201-20.

Sarkar D, Jung MK, Wang HJ. Alcohol and the Immune System. Alcohol Res. 2015;37(2):153–155.

Van doremalen N, Bushmaker T, Morris DH, et al. Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1. N Engl J Med. 2020.

Wang D, Hu B, Hu C, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA 2020.

Zou W. Immunosuppressive networks in the tumor environment and their therapeutic relevance. Nat Rev Cancer. 2005;5(4):263-74.

AJC1. Novel Coronavirus nCoV. CC BY-SA 2.0. 

Questions?