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Predictors of Mortality in COVID-19 Patients Presenting With Gastrointestinal Bleeding: A Retrospective

Mobin Rasapour1, Hamid Mohajer2, Erfan Sabouri1

  • 1Clinical Research Development Center, Najafabad Branch Islamic Azad University Najafabad Iran.

Health Science Reports
|June 30, 2026
PubMed

Insights

Gastrointestinal bleeding (GIB) occurred in 1.5% of Coronavirus disease 2019 (COVID-19) patients, with bleeding during hospitalization significantly increasing mortality risk. Further research is needed to identify preventive strategies for GIB in COVID-19 patients.

Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Coronavirus disease 2019 (COVID-19) is a potentially fatal illness.
  • Gastrointestinal bleeding (GIB) is a significant cause of mortality in COVID-19 patients, with a prevalence of 1.5%-3%.

Purpose of the Study:

  • To evaluate the prevalence and mortality rate of GIB in COVID-19 patients.
  • To assess the role of potential risk factors in patient outcomes.

Main Methods:

  • Retrospective cross-sectional study of RT-PCR confirmed COVID-19 patients with overt GIB symptoms.
  • Data extraction on demographics, comorbidities, GIB manifestations, bleeding onset, and anticoagulant use.
  • Comparison of outcomes between patients alive and deceased 30 days post-discharge.

Main Results:

  • GIB occurred in 1.5% of 7243 COVID-19 patients; 63 were analyzed, with a 47.6% mortality rate.
  • Hematemesis and melena were the most common GIB manifestations, primarily indicating upper GIB.
  • GIB during hospitalization was significantly associated with mortality (p=0.001, OR=5.53).

Conclusions:

  • GIB developing during hospitalization is a prognostic factor for mortality in COVID-19 patients.
  • Further research is recommended to identify risk factors and preventive measures for GIB in COVID-19.
  • GIB management in COVID-19 patients requires careful consideration due to its high mortality impact.
Abstract

Keywords:
COVID‐19gastrointestinal bleedinghospitalizationmortality

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