A rare case of macroamylasemia in a patient with SARS-CoV-2 infection

Abstract Macroamylasemia is a rare condition affecting 0.5–1.5% of the population. Macroamylasemia should be suspected in a patient with a high serum alpha amylase level without an elevation in the urine alpha-amylase level. Serum amylase binds with other serum proteins like immunoglobulins A( 92%), immunoglobulins G (<30%), and others (<5%), forming macromolecular complexes that weigh more than 400 KDa. Nephrones are unable to secrete these macromolecules into the urine due to their large size, which causes the accumulation of these macromolecules in the serum. Patients with COVID-19 during seroconversion develop higher concentrations of SARS-CoV-2-specific immunoglobulins and different plasma proteins, which can bind with the alpha amylase molecules and cause macroamylasemia. In this case report, we report about a patient with mild COVID-19 who had persistently elevated serum amylase levels and was later diagnosed to have macroamylasemia. This is the first case of macroamylasemia reported in a patient with COVID-19 in the literature.