# COVID-19-Induced Hypertriglyceridemia Leading to Pancreatitis in a 51-Year-Old Female

## TL;DR

A 51-year-old woman with COVID-19 developed severe pancreatitis due to extremely high triglycerides, highlighting a rare but serious complication.

## Contribution

This case report highlights a novel association between COVID-19 and hypertriglyceridemia-induced pancreatitis.

## Key findings

- The patient had triglycerides of 11340 mg/dL and elevated lipase, indicating pancreatitis.
- Treatment with plasmapheresis, insulin, and remdesivir reduced triglycerides and improved symptoms.
- The case suggests a possible link between COVID-19 and severe hypertriglyceridemia leading to pancreatitis.

## Abstract

There are increasing reports of the effects of COVID-19 on the pancreas. Pancreatitis, as a result of hypertriglyceridemia, has also been reported. Hypothesized mechanisms include hemophagocytic lymphohistiocytosis (HLH) syndrome and acquired lipoprotein lipase (LPL) inhibitors. We present a 51-year-old female patient who presented with nausea, vomiting, and epigastric abdominal pain radiating to the back. On examination, she had generalized abdominal tenderness without guarding or rebound tenderness. Our workup revealed elevated lipase of 1150 units/L, triglycerides (TG) of 11340 mg/dL, and mild pancreatitis on an abdominal computed tomography (CT) scan. On day 2, she developed a new oxygen requirement and tested positive for COVID-19. She was treated with fluids and opiates for pancreatitis, plasmapheresis, and an insulin infusion to treat her hypertriglyceridemia. She was treated with remdesivir for an acute COVID-19 infection. Triglycerides decreased to <500 mg/dL with treatment, and she was discharged home on oral lipid-lowering agents. By discussing this case, we aim to shed light on the association between COVID-19 and hypertriglyceridemia, which can further lead to life-threatening complications such as acute pancreatitis. Further studies are needed to identify the exact mechanisms, preventive measures, and long-term effects of COVID-19 on triglycerides and the pancreas.