Gastrointestinal Bleeding in COVID-19 Patients: A Rapid Review
Alessandra Negro1,2,3,4,5, Giulia Villa1,2,3,4,5, Stefano Rolandi1,2,3,4,5
1Alessandra Negro, RN, is Head Nurse, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Insights
COVID-19 patients experience gastrointestinal bleeding (GIB) at rates from 1.1% to 13%, often involving mucosal damage. Conservative management and nutritional support are recommended, with caution regarding fecal diversion systems.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Internal Medicine
Background:
- Gastrointestinal (GI) manifestations of COVID-19 vary widely, with limited data on gastrointestinal bleeding (GIB).
- Understanding the incidence and risk factors for GIB in COVID-19 patients is crucial for effective management.
Purpose of the Study:
- To investigate the relationship between COVID-19 infection and gastrointestinal bleeding in adult patients.
- To determine the incidence rates and characteristics of GIB in the context of COVID-19.
Main Methods:
- A rapid review of literature was conducted.
- Searches were performed in PubMed, CINAHL, EMBASE, Cochrane Library, and Scopus databases.
- Data from 20 relevant studies were analyzed.
Main Results:
- The overall incidence of GIB in COVID-19 patients ranged from 1.1% to 13%.
- Bleeding primarily involved mucosal damage in the duodenum, stomach, colon, and rectum.
- Conservative management strategies were generally effective.
Conclusions:
- COVID-19 is associated with a notable incidence of gastrointestinal bleeding.
- Management should focus on conservative approaches, nutritional support, and careful consideration of interventions like fecal diversion systems.
- Larger cohort studies are necessary to further elucidate GIB in COVID-19.
Abstract:
The incidence of COVID-19 gastrointestinal manifestations has been reported to range from 3% to 61%. There are limited data on the incidence rates and risk factors associated with gastrointestinal bleeding (GIB) in patients with COVID-19. A rapid review has been designed to investigate whether there is a relationship between COVID-19 and GIB in adult patients. PubMed, CINAHL, EMBASE, Cochrane Library, and Scopus databases have been analyzed. A total of 129 studies were found; 29 full texts were analyzed, and of these, 20 were found to be relevant to the topic. The key findings of the included studies present an overall GIB rate in COVID-19 patients ranging from 1.1% to 13%. The bleeding involves mucosal damage of the duodenum, stomach, colon, and rectum. The management of gastrointestinal bleeding could be conservative. The use of fecal diversion systems for the management of diarrhea in COVID-19 patients should be minimized and closely evaluated for the risk of rectal mucosal damages and erosions. It is recommended to provide an accurate nutritional assessment; an early setting up of enteral nutrition, if not contraindicated, can help protect the gut mucosa of patients and restore normal intestinal flora. Larger cohort studies are needed to increase the information about this topic.
Related Concept Videos
01:28Esophageal Varices-II: Clinical Features and Management
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
01:23Gastritis III: Clinical Manifestations and Management
Clinical manifestations of acute gastritis
The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...
01:28Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
01:29Gastroesophageal Reflux Disease II: Clinical Features and Management
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
01:28Esophageal Perforation-II: Clinical Manifestations and Management
Clinical Manifestations:
01:17Assessment of the Gastrointestinal System I: Subjective Data
Health History
The initial step in assessing the GI system is obtaining a comprehensive health history. This includes inquiring about the patient's history or presence of problems...