Diarrhea due to SARS-CoV-2-Related Exocrine Pancreatic Insufficiency

Table 1

Comparison of key presenting features.

	Case 1	Case 2	Case 3
Demographic	A 38-year-old man with no significant medical condition	A 53-year-old man with prior history of hypertension and obesity	A 69-year-old man with hypertension and diastolic CHF
Social history	Smoker and alcohol use of around 4 to 6 drinks in a week for 10 years	Nonsmoker and alcohol use of 2–4 drinks in one year	No smoking and no alcohol use
COVID-19 presentation	Respiratory symptoms of cough and no shortness of breath	Cough, shortness of breath, and fever	Cough, shortness of breath, malaise, fever, and severe myalgia; he required high-flow oxygen during hospitalization
Diarrheal symptoms	Developed 2 to 3 days after hospital discharge	Present at the time of presentation	Developed diarrhea during hospitalization
Stool studies	Fecal fat present; fecal leucocyte negative	Fecal fat present; fecal leucocyte negative	Fecal fat present; fecal leucocyte negative
Fecal elastase (μ/dl)	110	Insufficient specimen	Could not be performed
Lactate dehydrogenase (U/dL)	410	450	680
C-reactive protein (mg/dL)	32	42	56
Pancreatic endocrine evaluation	Prediabetic	Random glucose of 98 gm/dL	Prediabetic
Time to respond to pancreatic enzyme supplements	1 day	1 day	1 day
Recurrence of symptoms with stopping pancreatic enzyme supplements	Present	Present	No interruption of therapy