COVID-19 Associated Acute Necrotizing Pancreatitis with Normal Serum Amylase and Lipase Levels: Report of an Unusual Finding

Coronaviruses are a large family of single-stranded RNA viruses infecting humans and animals, causing a multitude of symptoms. COVID-19 is not only known to affect the respiratory system, but shows unusual gastrointestinal complications. Pancreatitis can be caused by biliary stones, alcohol abuse, viruses, drug intake, metabolic syndromes, or trauma. Diagnosis of acute pancreatitis requires any two of the three criteria: acute onset of severe upper abdominal pain, consistent with pancreatitis; elevation of serum amylase or lipase, three times the upper limit of normal; and/or characteristic imaging findings. COVID-19 associated pancreatitis is thought to be mediated by the angiotensin-converting enzyme-2 receptor on the host cells, which are highly expressed in the pancreatic cells. Here, we report a unique case of acute necrotizing pancreatitis caused by COVID-19 with hyperglycemia and normal amylase and lipase levels.