Covid-19 and Digestive Endoscopy: Emergency Endoscopic Procedures and Risk Factors for Upper Gastrointestinal Bleeding

Abstract

BACKGROUND: The COVID-19 pandemic has changed digestive endoscopy services around the world. OBJECTIVE: This study aimed to measure the number of urgent/emergency endoscopic procedures performed in a Brazilian hospital, comparing it to the same period in the previous year, and to identify risk factors in COVID-19 patients undergoing endoscopic procedures for upper gastrointestinal bleeding (UGIB). METHODS: This was a retrospective, cross-sectional, observational, single-center study. The study evaluated urgent/emergency endoscopic procedures performed on adult patients from March to August in 2019 and 2020. The COVID-19 patients included were diagnosed using RT-PCR, aged over 18 years with complete medical record information. The variables evaluated were age, sex, comorbidities, length of stay, D-dimer, need for intensive care unit (ICU) and mechanical ventilation. Student’s t-test for independent samples or the non-parametric Mann-Whitney test was used to compare quantitative variables. Categorical variables were analyzed using Fisher’s exact test. A P-value <0.05 indicated statistical significance. RESULTS: A total of 130 urgent/emergency endoscopic procedures were performed in 2020 and 97 in 2019. During the study period, 631 patients were hospitalized due to COVID-19, of whom 16 underwent urgent/emergency endoscopic procedures, 10 (1.6%) due to UGIB. Of the variables analyzed, the need for ICU and/or mechanical ventilation during hospitalization was statistically significant as a risk factor for UGIB. CONCLUSION: This study showed increased urgent/emergency endoscopic procedures during the pandemic at the study site. Among the patients hospitalized with the novel coronavirus, there is a higher risk for UGIB in those needing ICU and/or mechanical ventilation.

Prevalence and outcomes of upper gastrointestinal bleeding in COVID‐19: A systematic review and meta‐analysis

“…After taking into account the title and abstract, 902 articles were further eliminated, leaving 87 papers that could be considered plausible for this analysis after passing the article review. Based on thorough review and inclusion criteria, 21 articles totaling 26,933 COVID‐19 were eventually included in this meta‐analysis 6,11–30 . Table 1 summarises the baseline characteristics of the studies that were included.…”

“…Based on thorough review and inclusion criteria, 21 articles totaling 26,933 COVID-19 were eventually included in this meta-analysis. 6,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] Table 1 summarises the baseline characteristics of the studies that were included. The included patients had a median age of 65 years, with 34% of them being female.…”