Gastrointestinal bleeding and endoscopic findings in critically and non‐critically ill patients with corona virus disease 2019 (COVID‐19): Results from Lean European Open Survey on SARS‐CoV‐2 (LEOSS) and COKA registries

URN to cite this document:: urn:nbn:de:bvb:355-epub-565036
DOI to cite this document:: 10.5283/epub.56503

Zellmer, Stephan ; Hanses, Frank

; Muzalyova, Anna ; Classen, Johanna ; Braun, Georg ; Piepel, Christiane ; Erber, Johanna ; Pilgram, Lisa ; Walter, Lorenz ; Göpel, Siri ; Wille, Kai

; Hower, Martin ; Rüthrich, Maria Madeleine ; Rupp, Jan

; Degenhardt, Christian ; Voigt, Ingo ; Borgmann, Stefan ; Stecher, Melanie ; Jakob, Carolin ; Dhillon, Christine ; Messmann, Helmut ; Ebigbo, Alanna ; Römmele, Christoph

License: Creative Commons Attribution Non-commercial No Derivatives 4.0
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Date of publication of this fulltext: 29 Feb 2024 12:28

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Background Corona virus disease 2019 (COVID-19) patients are at increased risk for thromboembolic events. It is unclear whether the risk for gastrointestinal (GI) bleeding is also increased. Methods We considered 4128 COVID-19 patients enrolled in the Lean European Open Survey on SARS-CoV-2 (LEOSS) registry. The association between occurrence of GI bleeding and comorbidities as well as medication were examined. In addition, 1216 patients from COKA registry were analyzed focusing on endoscopy diagnostic findings. Results A cumulative number of 97 patients (1.8%) with GI bleeding were identified in the LEOSS registry and COKA registry. Of 4128 patients from the LEOSS registry, 66 patients (1.6%) had a GI bleeding. The rate of GI bleeding in patients with intensive care unit (ICU) admission was 4.5%. The use of therapeutic dose of anticoagulants showed a significant association with the increased incidence of bleeding in the critical phase of disease. The Charlson comorbidity index and the COVID-19 severity index were significantly higher in the group of patients with GI bleeding than in the group of patients without GI bleeding (5.83 (SD = 2.93) vs. 3.66 (SD = 3.06), p < 0.01 and 3.26 (SD = 1.69) vs. 2.33 (SD = 1.53), p < 0.01, respectively). In the COKA registry 31 patients (2.5%) developed a GI bleeding. Of these, the source of bleeding was identified in upper GI tract in 21 patients (67.7%) with ulcer as the most frequent bleeding source (25.8%, n = 8) followed by gastroesophageal reflux (16.1%, n = 5). In three patients (9.7%) GI bleeding source was located in lower GI tract caused mainly by diverticular bleeding (6.5%, n = 2). In seven patients (22.6%) the bleeding localization remained unknown. Conclusion Consistent with previous research, comorbidities and disease severity correlate with the incidence of GI bleeding. Also, therapeutic anticoagulation seems to be associated with a higher risk of GI bleeding. Overall, the risk of GI bleeding seems not to be increased in COVID-19 patients.

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