Endoscopic findings are not different in patients with upper gastrointestinal bleeding with COVID-19

Authors : Fatma Ebru AKIN, Öykü TAYFUR YÜREKLİ, Mustafa TAHTACI, Osman ERSOY

Pages : 20-28

Doi:10.17941/agd.1275659

View : 11 | Download : 8

Publication Date : 2023-04-30

Article Type : Research Paper

Abstract :Background and Aims: Coronavirus disease-2019 is an emerging disease of global public health concern. We aimed to evaluate the demographic data, clinical properties, risk factors and endoscopy findings of coronavirus disease-2019 patients with upper gastrointestinal system bleeding. Materials and Method: Patients who underwent endoscopy for upper gastrointestinal bleeding between July 2, 2020 and January 29, 2021 and were diagnosed with severe acute respiratory syndrome coronavirus-2 confirmed by polymerase chain reaction were included in the study. In this retrospective study patients with gastrointestinal bleeding were compared as 1:2 case-control. Coronavirus disease-2019 patients who underwent endoscopy for upper gastrointestinal bleeding and the control group were compared retrospectively in terms of demographic data, comorbid diseases, bleeding symptom, drugs administered, laboratory parameters, time between bleeding symptom and endoscopy, endoscopy findings, gastrointestinal bleeding treatment, and mortality rates. Results: Forty Covid-19 patients insert ignore into journalissuearticles values(23 males, mean age ± SD, 65.92 ± 12.97); and 80 non-Covid-19 control patients insert ignore into journalissuearticles values(43 males, mean age ± SD, 66.17 ± 15.61); who underwent endoscopy for upper gastrointestinal bleeding were compared. The most common bleeding symptom was melena in both groups insert ignore into journalissuearticles values(50% vs 60%);. Hospitalization in intensive care unit insert ignore into journalissuearticles values(47.5% vs 20%, P = 0.004); and need for mechanic ventilation insert ignore into journalissuearticles values(22.5% vs 5%, p = 0.006);, use of corticosteroids were more common in coronavirus disease-2019 group insert ignore into journalissuearticles values(30% vs. 2.5%, p = 0.000);. The need for erythrocyt replacement were not different between the groups [median insert ignore into journalissuearticles values(min - max); 1.5 insert ignore into journalissuearticles values(0 - 13); vs 0.5 insert ignore into journalissuearticles values(0 - 22);, p = 0.397]. Use of low molecular weight heparin was statistically more common in coronavirus disease-2019 group insert ignore into journalissuearticles values(32.5% vs 5%, p=0.00);. Time elapsed until the performance of endoscopy in terms of hours was significantly longer in coronavirus disease-2019 group insert ignore into journalissuearticles values(62.97 ± 84.59 vs. 21.85 ± 33.91, p = 0.006);. The most common endoscopic finding was gastroduodenal ulcer in both groups. No significant differences were seen in terms of rebleeeding rates. Mortality rate was statistically higher in coronavirus disease-2019 group insert ignore into journalissuearticles values(37.5% vs 8.8%, p = 0.000);. Conclusions: Until more precise guidelines for the management of gastrointestinal bleeding in COVID-19 patients are developed, a case-by-case decision should be made on whether to perform endoscopy and the timing of the procedure, after multidisciplinary assessments are made in terms of patient status, response to medical therapy, treatment resources, and assessment of risks.
Keywords : Kovid 19, gastrointestinal kanama, antikogülan