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Clinical and endoscopic analysis of gastrointestinal bleeding during COVID-19 full-blown pandemic: a retrospective
Jing-Wei Liu1, Yue Sui1, Jun-Hui Lu1
1The First Clinical Medical College, Shanxi Medical University, Taiyuan, China.
Insights
During the COVID-19 pandemic, gastrointestinal bleeding (GIB) patients saw increased ICU admissions and anticoagulant use. Endoscopic intervention rates decreased, but mortality and hospital stay remained unchanged.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Critical Care Medicine
Background:
- Gastrointestinal bleeding (GIB) management during the COVID-19 pandemic lacked sufficient evidence.
- This study analyzed clinical and endoscopic characteristics of GIB patients during the COVID-19 pandemic.
Purpose of the Study:
- To compare GIB patient characteristics and outcomes between the initial and full-blown stages of the COVID-19 pandemic.
- To identify changes in management strategies and patient outcomes during the COVID-19 pandemic.
Main Methods:
- Retrospective analysis of GIB patients divided into two groups: initial COVID-19 stage (Group 1) and full-blown COVID-19 pandemic (Group 2).
- Comparison of 30-day mortality, ICU admission, laboratory results, blood transfusions, anticoagulant therapy, NSAID use, and endoscopy frequency between groups.
Main Results:
- GIB patients during the full-blown pandemic showed higher prothrombin time, APTT, d-dimer, and PTA.
- Increased ICU admissions, anticoagulant therapy, and NSAID use were observed.
- Endoscopy frequency significantly decreased during the full-blown pandemic compared to the initial stage.
Conclusions:
- GIB patients during the COVID-19 full-blown pandemic had a higher likelihood of requiring ICU admission.
- Despite a reduced endoscopic intervention rate, no significant differences were found in hospital stay, blood transfusion needs, rebleeding rates, or mortality.
Background:
Although endoscopy is a commonly used technique in patients with gastrointestinal bleeding (GIB), there is currently insufficient evidence to inform clinicians on how to manage patients with gastrointestinal bleeding during COVID-19 full-blown pandemic. Herein, we analyzed the clinical and endoscopic characteristics of GIB in patients hospitalized during COVID-19 full-blown pandemic.
Methods:
Patients with GIB during the initial stage of COVID-19 pandemic and COVID-19 full-blown pandemic were enrolled and defined as Group 1 and Group 2, respectively. Comeparing the differences in the 30 days mortality, the need for intensive care unit (ICU) level of care, laboratory examination, blood transfusion and anticoagulant therapy, use of non-steroidal anti-inflammatory drugs (NSAIDs), frequency of endoscopy, and examination results between the two groups.
Results:
Compared to GIB patients in initial stage of COVID-19 pandemic, prothrombin time (PT) (15.45 s vs 13.84 s, p = 0.003), activated partial prothrombin time (APTT) (33.13 s vs 27.28 s, p = 0.001), d-dimer (mg/L) (730.44 vs 507.22, p = 0.041), and prothrombin activity (PTA) (75.79% vs 76.61%, p = 0.001) were higher in GIB patients during COVID-19 pandemic. Furthermore, an increased need for ICU stays (%) (16.9% vs 3.8%, p = 0.020) and anticoagulant therapy (%) (38.2% vs 5.7%, p < 0.001), higher use of NSAIDs (%) (25.8% vs 3.8%, p = 0.001) and lower frequency of endoscopy (%) (41.6% vs 73.6%, p < 0.001) were seen during COVID-19 full-blown pandemic.
Conclusion:
During COVID-19 full-blown pandemic, the number of patients with GIB increased significantly; these patients were more likely to require ICU admission. Although the endoscopic intervention rate was significantly reduced in COVID-19 patients, there were no significant differences in hospital stay, blood transfusion requirements, rebleeding rate, and mortality.
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