Serum amylase elevation is associated with adverse clinical outcomes in patients with coronavirus disease 2019

作者：Ganxun Li, Tongji Multidisciplinary Team for Treating COVID-19 (TTTC), Tongtong Liu, Guan-nan Jin, Tianhong Li, Junnan Liang, Qian Chen, Lin Chen, Wei Wang, Yuwei Wang, Jia Song, Huifang Liang, Chuanhan Zhang, Peng Zhu, Wanguang Zhang, Zeyang Ding, Xiaoping Chen, Bixiang Zhang · 发表于：Aging · 年份：2021 · DOI：10.18632/aging.203653 · 被引用次数：12 · 研究领域：Pancreatitis Pathology and Treatment、COVID-19 Clinical Research Studies、Pancreatic and Hepatic Oncology Research

OBJECTIVE: Hyperamylasemia was found in a group of patients with COVID-19 during hospitalization. However, the evolution and the clinical significance of hyperamylasemia in COVID-19, is not well characterized. DESIGN: In this retrospective cohort study, the epidemiological, demographic, laboratory, treatment and outcome information of 1,515 COVID-19 patients with available longitudinal amylase records collected from electronic medical system were analyzed to assess the prevalence and clinical significance of hyperamylasemia in this infection. Associated variables with hyperamylasemia in COVID-19 were also analyzed. RESULTS: Of 1,515 patients, 196 (12.9%) developed hyperamylasemia, among whom 19 (1.3%) greater than 3 times upper limit of normal (ULN) and no clinical acute pancreatitis was seen. Multivariable ordered logistic regression implied older age, male, chronic kidney disease, several medications (immunoglobin, systemic corticosteroids, and antifungals), increased creatinine might be associated with hyperamylasemia during hospitalization. Restricted cubic spline analysis indicated hyperamylasemia had a J-shaped association with all-cause mortality and the estimated hazard ratio per standard deviation was 2.85 (2.03-4.00) above ULN. Based on the multivariable mixed-effect cox or logistic regression model taking hospital sites as random effects, elevated serum amylase during hospitalization was identified as an independent risk factor associated with in-hospital death and...