Incidence, Clinical Characteristics, Risk Factors, and Outcomes of Upper Gastrointestinal Bleeding in Patients With COVID-19

González, Rebeca González; Jacob, Javier; Miró, Òscar; Llorens, Pere; Jiménez, Sònia; Castillo, Juan González del; Burillo-Putze, Guillermo; Martín, A.; Martín‐Sánchez, Francisco Javier; Lamberechts, Jorge García; Alquézar‐Arbé, Aitor; Higa-Sansone, Leopoldo; Martín, Sara Gayoso; Carbajosa, Virginia; Chaib, Fahd Beddar; Salido, Manuel; González, María José Marchena; López, Ricardo Calvo; Martínez, Félix González; Monzo, José Pavón; Herrera, Sergio; Valdés, Ana Patricia Niembro; Motto, Eva Quero; Amez, José María Ferreras; Piñera-Salmerón, Pascual

doi:10.1097/mcg.0000000000001465

Cited by 17 publications

(45 citation statements)

References 26 publications

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“…13,14 Similarly, two studies had reported the clinical manifestations (abdominal pain, diarrhea) among 455 patients. 12,13 Although these parameters did not show heterogeneity in our analysis, we strongly recommend our readers to interpret these results with caution. Future case control studies are needed to evaluate the outcomes of risk factors, characteristics and outcomes associated with gastrointestinal hemorrhage in COVID-19 patients, and to share descriptive data in open access data repositories.…”

Section: Limitations Of the Studymentioning

confidence: 59%

“…All of the included studies were retrospective cohort studies. [12][13][14] A h e a d o f p r i n t : We used Duval and Tweedy's trim and fill method to determine missing studies according to the random effect model on either side of the mean effect of the funnel plot. The method identified that two studies were missing on the right side of the standard mean effect.…”

Section: Resultsmentioning

confidence: 99%

“…4D) suggested higher intensive care unit admissions for gastrointestinal bleeding cases with COVID-19, with no heterogeneity (I 2 : 0%). Mortality: The incidence of mortality was evaluated by two studies 12,14 with a rate ratio of (1.13, 95% C.I: 0.35 to 3.67, p=0.83), suggesting higher mortality for gastrointestinal bleeding cases with COVID-19, with no heterogeneity (I 2 : 0%) (Fig. 4E).…”

Section: Gastroduodenal Ulcer Outcomementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…To date, only few individual case control studies have attempted to evaluate the incidence of different types of gastrointestinal lesions in COVID-19 patients [12][13][14] with conflicting results. While one study has reported a moderate incidence of esophagitis (28.9%) (Gonzalez et al) 12 , others have reported a low incidence, ranging between 3 to 5%. 13,14 These contradicting results, together with the lack of meta-analysis data and consensus on the risk factors, characteristics, and outcomes of gastrointestinal hemorrhage in COVID-19 patients, present challenges for clinicians.…”

Section: Introductionmentioning

confidence: 99%

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Characteristics, risk factors and outcomes of gastrointestinal hemorrhage in COVID-19 patients: A meta-analysis

Chen¹,

Ying

2021

Pak J Med Sci

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Meta Analysis/Original Research Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a cause of coronavirus disease 2019 (COVID-19), mainly targets the respiratory system. However, recent studies also show its role in causing gastrointestinal hemorrhage, potentially affecting morbidity and mortality-related outcomes of the patients. There is still no consensus on the risk factors, characteristics, and the overall outcome of the gastrointestinal hemorrhage in COVID-19 patients. The main aim of this study was to summarize current evidence, assessing risk factors that promote the onset of gastrointestinal hemorrhage in COVID-19 patients, and to compare the incidences of the different sites of gastrointestinal lesions, the events of abdominal pain, diarrhea, intensive care unit admissions, and mortality between COVID-19 patients with or without gastrointestinal bleeding. Methods: A search of the academic literature was performed according to the PRISMA guidelines across five databases i.e., Web of Science, EMBASE, CENTRAL, Scopus, and MEDLINE. A random-effect meta-analysis was conducted to analyze the influence of the history of drugs consumption, gastrointestinal bleeding, the different incidence of gastrointestinal lesions, events of abdominal pain, intensive care unit (ICU) admission, and mortality between COVID-19 patients with/without gastrointestinal bleeding. Results: Out of 458 studies, three eligible studies with 663 participants (mean age: 69.7 ± 4.3 years) were included. A meta-analysis showed a medium-to-large influence of the history of gastrointestinal bleeding (Hedge’s g: 1.01) and anticoagulant drug consumption (g: 0.33) on the gastrointestinal bleeding in COVID-19 patients. Moreover, the incidence of gastroduodenal ulcers was higher as compared to esophagitis (37.5% versus 9.9%). Conclusions: The study provides preliminary evidence regarding the risk factors associated with the onset of gastrointestinal hemorrhage among COVID-19 patients. The study also outlines the characteristics and the outcomes of gastrointestinal hemorrhage in COVID-19 patients. doi: https://doi.org/10.12669/pjms.37.5.4351 How to cite this:Chen J, Hang Y. Characteristics, risk factors and outcomes of gastrointestinal hemorrhage in COVID-19 patients: A meta-analysis. Pak J Med Sci. 2021;37(5):---------. doi: https://doi.org/10.12669/pjms.37.5.4351 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Limitations Of the Studymentioning

confidence: 59%

Section: Resultsmentioning

confidence: 99%

Section: Gastroduodenal Ulcer Outcomementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Characteristics, risk factors and outcomes of gastrointestinal hemorrhage in COVID-19 patients: A meta-analysis

Chen¹,

Ying

2021

Pak J Med Sci

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

Rathore,

Wint,

Goyal

et al. 2024

Reviews in Medical Virology

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Upper gastrointestinal bleeding (UGIB) in COVID‐19 presents challenges in patient management. Existing studies lack comprehensive review due to varied designs, samples, and demographics. A meta‐analysis can provide valuable insights into the incidence, features, and outcomes of UGIB in COVID‐19. A comprehensive literature search was carried out using several databases. We considered all appropriate observational studies from all over the world. Mantel‐Haenszel odds ratios and associated 95% confidence intervals (CIs) were produced to report the overall effect size using random effect models. Besides, Random effects models were used to calculate the overall pooled prevalence. Funnel plots, Egger regression tests, and Begg‐Mazumdar's rank correlation test were used to appraise publication bias. Data from 21 articles consisting of 26,933 COVID‐19 patients were considered. The pooled estimate of UGIB prevalence in patients admitted with COVID‐19 across studies was 2.10% (95% CI, 1.23–3.13). Similarly, the overall pooled estimate for severity, mortality, and rebleeding in COVID‐19 patients with UGIB was 55% (95% CI, 37.01–72.68), 29% (95% CI, 19.26–40.20) and 12.7% (95% CI, 7.88–18.42) respectively. Further, UGIB in COVID‐19 patients was associated with increased odds of severity (OR = 3.52, 95% CI 1.80–6.88, P = 0.001) and mortality (OR = 2.16, 95% CI 1.33–3.51, P = 0.002) compared with patients without UGIB. No significant publication bias was evident in the meta‐analysis. The results of our study indicate that UGIB in individuals with COVID‐19 is linked to negative outcomes such as severe illness, higher mortality rates, and an increased risk of re‐bleeding. These findings highlight the significance of identifying UGIB as a significant complication in COVID‐19 cases and emphasise the importance of timely clinical assessment and proper treatment.

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Clinical and Endoscopic Outcomes in COVID-19 Patients With Gastrointestinal Bleeding

Ashktorab

Russo

Oskrochi

et al. 2022

Gastro Hep Advances

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Incidence, Clinical Characteristics, Risk Factors, and Outcomes of Upper Gastrointestinal Bleeding in Patients With COVID-19

Cited by 17 publications

References 26 publications

Characteristics, risk factors and outcomes of gastrointestinal hemorrhage in COVID-19 patients: A meta-analysis

Characteristics, risk factors and outcomes of gastrointestinal hemorrhage in COVID-19 patients: A meta-analysis

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

Clinical and Endoscopic Outcomes in COVID-19 Patients With Gastrointestinal Bleeding

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