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 

作者机构：Lee Kong Chian School of MedicineNanyang Technological UniversitySingapore 308232Singapore Department of General SurgeryTan Tock Seng HospitalSingapore 308433Singapore Surgical Science Training CentreTan Tock Seng HospitalSingapore 308433Singapore 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2023年第29卷第13期

页      面：2050-2063页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：COVID-19 Infections Pancreatic diseases Pancreatitis Post-acute COVID-19 syndrome 

摘      要：BACKGROUND Acute pancreatitis(AP)is a disease spectrum ranging from mild to severe *** 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 *** case reports or small case series are unable to accurately determine the cause-effect relationship between COVID-19 and *** To establish whether COVID-19 is a cause of AP using the modified Naranjo scoring *** A systematic review was conducted on PubMed,World of Science and Embase for articles reporting COVID-19 and AP from inception to August *** criteria were cases of AP which were not reported to be due to COVID-19 infection,age18 years old,review articles and retrospective cohort *** 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 *** 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 *** of the modified Naranjo scoring system is as follows:≤3:Doubtful,4-6:Possible,≥7:Probable *** 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 *** mean age was 47.8(range 18-94)*** of patients(73.3%)had≤7 d between onset of COVID-19 infection and diagnosis of *** were only 45(59.2%)patients who had adequate investigations to rule out common aetiologies(gallstones,choledocholithiasis,alcohol,hypertriglyceridemia,hypercalcemia and trauma)of *** G4 testing was conducted in 9(13.5%)patients to rule out autoimmune *** 5(6.6%)patients underwent endoscopic ultra