Background: COVID-19 presented as pulmonary and extra pulmonary manifestations. Acute pancreatitis is an inflammatory disorder that affects the pancreas and sometimes adjacent tissues. Studies showed a possible effect of COVID-19 on pancreas as many patients infected with COVID-19 presented with Acute pancreatitis.Aim of Study: The aim of our study is to compare the effects of SARS-CoV-2 on Acute pancreatitis in covid and non-covid patients regarding presentation, severity, complications and prognosis of Acute pancreatitis.Patients and Methods: A prospective comparative case control study. It was performed in the surgical unit of Baghdad Teaching Hospital in Medical City from January 1, 2021 to December 31, 2021. The study included 80 patients diagnosed with Acute pancreatitis, 40 of them COVID-19 positive, compared with the other 40 patients who were covid negative to assess the effect of the virus on presentation, severity, complications and prognosis of Acute pancreatitis.Results:The results revealed statistical significant effect between severity of both Acute pancreatitis and COVID-19 where, 87.5% of critical COVID-19 developed severe Acute pancreatitis while, 85.7% who were mild COVID-19 showed mild Acute pancreatitis. This study showed increase in respiratory symptoms (dyspnea and decrease SPO2%) in case group (COVID-19 positive) patients. The prevalent etiology in both groups (case and control) was biliary followed by alcoholic and idiopathic. Certain laboratory tests increased in case group. Our results revealed increase in systemic complications (Pleural effusion and Respiratory failure) in case group. Also, results showed increase in the use of anticoagulant agents in treatment of case group compared to control group. Hospital stay was longer in case group without statistical significance. Conclusion:The severity of COVID-19 and acute pancreatitis among the case group are found to be correlated.  SARS-CoV-2 may cause direct or indirect harm to start acute pancreatitis in cases where the cause of AP is idiopathic. It was more common for the case group to experience respiratory problems such respiratory failure and pleural effusion. Some of laboratory tests in the case group had significantly higher results. Recovery was higher in the control group (97%) while death was higher in the case group (25%) without statistical significance.

Index Terms- COVID-19 ; Acute pancreatitis; Baghdad Teaching Hospital