Decline in acute upper gastrointestinal bleeding during COVID-19 pandemic after initiation of lockdown in Austria
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Published on: November 15, 2024
Andreas Schmiderer1, Hubert Schwaighofer1, Lukas Niederreiter1
1Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology and Metabolism, Medical University Innsbruck, Innsbruck, Austria.
Insights
The COVID-19 lockdown in Austria led to a significant 40.7% reduction in acute upper gastrointestinal (GI) bleeding cases. Nonvariceal bleeding events saw a notable decline, while variceal hemorrhage rates remained stable.
Area of Science:
- Gastroenterology
- Epidemiology
- Public Health
Background:
- The COVID-19 pandemic necessitated widespread public health interventions, including national lockdowns.
- Austria implemented a national lockdown on March 16, 2020, to curb the spread of COVID-19.
- The impact of such lockdowns on acute medical conditions, specifically upper gastrointestinal bleeding, was not well-understood.
Purpose of the Study:
- To investigate the effect of the national COVID-19 lockdown on the incidence of acute upper gastrointestinal (GI) bleeding in Austria.
- To analyze changes in the frequency of specific types of upper GI bleeding, namely variceal and nonvariceal, before and after the lockdown.
Main Methods:
- A retrospective study involving 98 Austrian hospitals performing emergency endoscopies.
- Data collection focused on upper GI endoscopies for hematemesis or melena with visible bleeding signs.
- The study compared data from the three weeks preceding the lockdown (Week 9) with the three weeks following its initiation (Week 14).
Main Results:
- A 40.7% reduction in total upper GI bleeding events was observed post-lockdown (341 cases) compared to pre-lockdown (575 cases).
- Nonvariceal bleeding events decreased by 54.6% after the lockdown compared to the pre-lockdown period.
- Rates of variceal hemorrhage showed no significant change between the pre-lockdown and post-lockdown periods.
Conclusions:
- The national lockdown in Austria was associated with a substantial decrease in acute upper GI bleeding events.
- The reduction was primarily driven by a decline in nonvariceal bleeding cases.
- These findings highlight the significant impact of public health measures on healthcare utilization for conditions like upper GI bleeding.
Background:
COVID-19 has spread rapidly around the world. The Austrian government implemented a lockdown on 16 March to contain further spread of the disease. We investigated the effects of lockdown on acute upper gastrointestinal (GI) bleeding in Austria.
Methods:
We contacted 98 Austrian hospitals performing emergency endoscopies. The hospitals were asked to report upper GI endoscopies performed for recent hematemesis, melena, or both, and exhibiting endoscopically visible signs of bleeding. The study period was from 3 weeks before (calendar Week 9) to 3 weeks after (Week 14) initiation of the lockdown.
Results:
61 % of Austrian hospitals, and importantly all major state hospitals, responded. A total of 575 upper GI bleedings occurred during the 3 weeks before and 341 during the 3 weeks after initiation of lockdown (40.7 % reduction). There was a 54.6 % decline in nonvariceal bleeding events at Week 14 compared with Week 9 (89 vs. 196), whereas rates of variceal hemorrhage did not change (15 vs. 17).
Conclusions:
National lockdown resulted in a dramatic decrease in upper GI bleeding events in Austrian hospitals.
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