Clinical and Endoscopic Outcomes in COVID-19 Patients With Gastrointestinal Bleeding

Hassan Ashktorab; Tiziano Russo; Gholamreza Oskrochi; Giovanni Latella; Sara Massironi; Martina Luca; Lakshmi G. Chirumamilla; Adeyinka O. Laiyemo; Hassan Brim

Gastro Hep Advances (Jan 2022)

Clinical and Endoscopic Outcomes in COVID-19 Patients With Gastrointestinal Bleeding

Hassan Ashktorab,
Tiziano Russo,
Gholamreza Oskrochi,
Giovanni Latella,
Sara Massironi,
Martina Luca,
Lakshmi G. Chirumamilla,
Adeyinka O. Laiyemo,
Hassan Brim

Affiliations

Hassan Ashktorab: Department of Medicine, Department of Pathology and Cancer Center, Howard University College of Medicine, Washington, District of Columbia; Correspondence: Address correspondence to: Hassan Ashktorab, PhD, Email:[email protected] University College of Medicine, 2041 Georgia Avenue. N.W., Washington, District of Columbia 20060.
Tiziano Russo: Department of Medicine, Department of Pathology and Cancer Center, Howard University College of Medicine, Washington, District of Columbia
Gholamreza Oskrochi: College of Engineering and Technology, American University of the Middle East, Egaila, Kuwait
Giovanni Latella: Gastroenterology, Hepatology and Nutrition Division, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
Sara Massironi: Division of Gastroenterology and Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca, and European Reference Network on Hepatological Diseases (ERN RARE-LIVER), San Gerardo Hospital, Monza, Italy
Martina Luca: Division of Gastroenterology and Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca, and European Reference Network on Hepatological Diseases (ERN RARE-LIVER), San Gerardo Hospital, Monza, Italy
Lakshmi G. Chirumamilla: Department of Medicine, Department of Pathology and Cancer Center, Howard University College of Medicine, Washington, District of Columbia
Adeyinka O. Laiyemo: Department of Medicine, Department of Pathology and Cancer Center, Howard University College of Medicine, Washington, District of Columbia
Hassan Brim: Department of Medicine, Department of Pathology and Cancer Center, Howard University College of Medicine, Washington, District of Columbia

Journal volume & issue: Vol. 1, no. 4
pp. 487 – 499

Abstract

Read online

Background and Aims: Over 404 million people worldwide have been infected with coronavirus disease–2019 (COVID-19), 145 million in the United States (77 million) and Europe (151 million) alone (as of February 10, 2022). This paper aims to analyze data from studies reporting gastrointestinal bleeding (GIB) and/or endoscopic findings in COVID-19 patients in Western countries. Methods: We conducted a systematic review of articles on confirmed COVID-19 cases with GIB in Western countries published in PubMed and Google Scholar databases from June 20, 2020, to July 10, 2021. Results: A total of 12 studies reporting GIB and/or endoscopic findings in 808 COVID-19 patients in Western countries were collected and analyzed. Outcomes and comorbidities were compared with 18,179 non-GIB COVID-19 patients from Italy and the United States. As per our study findings, the overall incidence of GIB in COVID-19 patients was found to be 0.06%. When compared to the non-GIB cohort, the death rate was significantly high in COVID-19 patients with GIB (16.4% vs 25.4%, P < .001, respectively). Endoscopic treatment was rarely necessary, and blood transfusion was the most common GIB treatment. The most common presentation in GIB patients is melena (n = 117, 47.5%). Peptic, esophageal, and rectal ulcers were the most common endoscopic findings in upper (48.4%) and lower (36.4%) endoscopies. The GIB cohort had worse outcomes and higher incidence of hypertension (61.1%), liver disease (11.2%), and cancer (13.6%) than the non-GIB cohort. Death was strongly associated with hypertension (P < .001, r = 0.814), hematochezia (P < .001, r = 0.646), and esophagogastroduodenoscopy (P < .001, r = 0.591) in COVID-19 patients with GIB. Conclusion: Overall, the incidence of GIB in COVID-19 patients is similar to that estimated in the overall population, with melena being the most common presentation. The common endoscopic findings in GIB COVID-19 patients were ulcers, esophagitis, gastritis, and colitis. Patients with GIB were more prone to death than non-GIB COVID-19 patients.

Published in Gastro Hep Advances

ISSN: 2772-5723 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the digestive system. Gastroenterology
Website: https://www.sciencedirect.com/journal/gastro-hep-advances

About the journal

Abstract

Keywords