Surgery and emergency gastrointestinal endoscopy during the Covid-19 pandemic

Bujanda, Luís; Arratibel, Paula; Gil, Inés Moreno; Torrente, Silvia; Martos, Maider; Navascués, Jose María Enriquez

doi:10.1016/j.gastrohep.2020.07.002

Cited by 5 publications

(4 citation statements)

References 1 publication

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“…In the era of COVID-19, therefore, a decrease in endoscopies was observed [ 81 , 82 ]. However, in some cases it was deemed necessary to perform endoscopy to manage GIB.…”

Section: Discussionmentioning

confidence: 99%

The Prevalence of Gastrointestinal Bleeding in COVID-19 Patients: A Systematic Review and Meta-Analysis

Karlafti,

Tsavdaris,

Kotzakioulafi

et al. 2023

Medicina

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Introduction: Severe acute respiratory syndrome coronavirus 2 caused the coronavirus disease of 2019 (COVID-19), which rapidly became a pandemic, claiming millions of lives. Apart from the main manifestations of this infection concerning the respiratory tract, such as pneumonia, there are also many manifestations from the gastrointestinal tract. Of these, bleeding from the gastrointestinal tract is a significant complication quite dangerous for life. This bleeding is divided into upper and lower, and the primary pathophysiological mechanism is the entering of the virus into the host cells through the Angiotensin-converting enzyme 2 receptors. Also, other comorbidities and the medication of corticosteroids and anticoagulants are considered to favor the occurrence of gastrointestinal bleeding (GIB). Methods: This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and the studies were searched in two different databases (Scopus and PubMed) from November 2019 until February 2023. All studies that reported GIB events among COVID-19 patients were included. Results: 33 studies were selected and reviewed to estimate the prevalence of GIB. A total of 134,905 patients with COVID-19 were included in these studies, and there were 1458 episodes of GIB. The prevalence of GIB, in these 33 studies, ranges from 0.47% to 19%. This range of prevalence is justified by the characteristics of the COVID-19 patients. These characteristics are the severity of COVID-19, anticoagulant and other drug treatments, the selection of only patients with gastrointestinal manifestations, etc. The pooled prevalence of gastrointestinal bleeding was estimated to be 3.05%, rising to 6.2% when only anticoagulant patients were included. Conclusions: GIB in COVID-19 patients is not a rare finding, and its appropriate and immediate treatment is necessary as it can be life-threatening. The most common clinical findings are melena and hematemesis, which characterize upper GIB. Treatment can be conservative; however, endoscopic management of bleeding with embolization is deemed necessary in some cases.

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“…In the era of COVID-19, therefore, a decrease in endoscopies was observed [ 81 , 82 ]. However, in some cases it was deemed necessary to perform endoscopy to manage GIB.…”

Section: Discussionmentioning

confidence: 99%

The Prevalence of Gastrointestinal Bleeding in COVID-19 Patients: A Systematic Review and Meta-Analysis

Karlafti,

Tsavdaris,

Kotzakioulafi

et al. 2023

Medicina

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“…Endoscopies were less frequently performed in the COVID cohort, particularly in patients between 1 and 5 years of age. In a descriptive study in Spain, a similar trend was characterized with a 58% decrease in upper endoscopies for FBIs during the pandemic (32). Conservative management may have been preferred relative to endoscopic removal during the early months of the COVID pandemic, when operating room capacity and other resources were severely strained (33).…”

Section: Foreign Body Ingestions During Covid-19mentioning

confidence: 94%

Epidemiology of Pediatric Foreign Body Ingestions Amidst the Coronavirus 2019 Pandemic at a Tertiary Care Children’s Hospital

et al. 2022

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“…However, during the COVID-19 pandemic, the number of emergency upper GI endoscopies performed reportedly decreased by 30%-40%. 8 The potential effect of this on the mortality of patients with NVUGIB is a matter of concern. However, only limited studies have investigated the endoscopic management and clinical outcomes of these patients during the COVID-19 pandemic.…”

Section: Introductionmentioning

confidence: 99%

“…Thus, it must be conducted rapidly after the patient arrives at the hospital. However, during the COVID‐19 pandemic, the number of emergency upper GI endoscopies performed reportedly decreased by 30%–40% 8 . The potential effect of this on the mortality of patients with NVUGIB is a matter of concern.…”

Section: Introductionmentioning

confidence: 99%

Impact of the COVID‐19 pandemic on the time to emergency endoscopy and clinical outcomes in patients with upper gastrointestinal bleeding

Komatsu,

Sato,

Kuroki

et al. 2023

DEN Open

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ObjectivesTo investigate endoscopic management and clinical outcomes in patients with non‐variceal upper gastrointestinal (GI) bleeding during the coronavirus disease 2019 pandemic.MethodsWe retrospectively analyzed the data of 332 patients with non‐variceal upper GI bleeding who underwent emergency upper GI endoscopy at three hospitals during the pandemic (April 2020–June 2021) and before the pandemic (January 2019–March 2020). The number of emergency upper GI endoscopies, time from hospital arrival to endoscopy, mortality within 30 days, rebleeding within 30 days, interventional radiology (IVR)/surgery requirement, composite outcome, rates of endoscopic hemostasis procedures, and second‐look endoscopy were investigated using logistic regression.ResultsOverall, 152 and 180 patients underwent emergency upper GI endoscopies during and before the pandemic, respectively. The mean time from arrival to endoscopy was longer during the pandemic than before it (11.7 vs. 6.1 h, p < 0.01). Multivariate analysis revealed that mortality within 30 days (odds ratio [OR]: 2.27, p = 0.26), rebleeding within 30 days (OR: 0.43, p = 0.17), IVR/surgery requirement (OR: 1.79, p = 0.33), and composite outcome (OR: 0.98, p = 0.96) did not differ significantly between the periods; conversely, endoscopic hemostasis procedures (OR: 0.38, p < 0.01) and second‐look endoscopies (OR: 0.04, p < 0.01) were less likely to be performed during the pandemic than before it.ConclusionsAlthough the time from arrival to endoscopy was significantly longer during the pandemic, it did not affect mortality and rebleeding.

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Surgery and emergency gastrointestinal endoscopy during the Covid-19 pandemic

Cited by 5 publications

References 1 publication

The Prevalence of Gastrointestinal Bleeding in COVID-19 Patients: A Systematic Review and Meta-Analysis

The Prevalence of Gastrointestinal Bleeding in COVID-19 Patients: A Systematic Review and Meta-Analysis

Epidemiology of Pediatric Foreign Body Ingestions Amidst the Coronavirus 2019 Pandemic at a Tertiary Care Children’s Hospital

Impact of the COVID‐19 pandemic on the time to emergency endoscopy and clinical outcomes in patients with upper gastrointestinal bleeding

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