Acute Gastrointestinal Bleeding in COVID-19 Patients: A Systematic Review and Meta-Analysis
Clinical Endoscopy 2021³â 54±Ç 4È£ p.534 ~ p.541
(Iqbal Umair) - Geisinger Medical Center Department of Gastroenterology and Hepatology
(Anwar Hafsa) - Capital Health Regional Medical Center Department of Internal Medicine
(Siddiqui Hafiz Umair) - Cleveland Clinic Foundation Department of Surgery
(Khan Muhammad Ali) - University of Texas MD Anderson Cancer Center Houston Department of Gastroenterology and Hepatology
(Kamal Faisal) - University of Tennessee at Memphis Health Sciences Center Department of Gastroenterology and Hepatology
(Confer Bradley D.) - Geisinger Medical Center Department of Gastroenterology and Hepatology
(Khara Harshit S.) - Geisinger Medical Center Department of Gastroenterology and Hepatology
Abstract
Background/Aims: More than 100 million people to date have been affected by the coronavirus disease-2019 (COVID-19) pandemic. Patients with COVID-19 have a higher risk of bleeding complications. We performed a systematic review and meta-analysis to evaluate the outcomes of COVID-19 patients with signs and symptoms of acute gastrointestinal bleeding (GIB).
Methods: A systematic literature search was carried out for articles published until until November 11, 2020, in the Embase, MEDLINE, Web of Science, and Cochrane Library databases. We included studies on COVID-19 patients with signs and symptoms of GIB.
Results: Our search yielded 49 studies, of which eight with a collective 127 patients (86 males and 41 females) met our inclusion criteria. Conservative management alone was performed in 59% of the patients, endoscopic evaluation in 31.5%, and interventional radiology (IR) embolization in 11%. Peptic ulcer disease was the most common endoscopic finding, diagnosed in 47.5% of the patients. Pooled overall mortality was 19.1% (95% confidence interval [CI]; 12.7%-27.6%) and pooled mortality secondary to GIB was 3.5% (95% CI; 1.3%?9.1%). The pooled risk of rebleeding was 11.3% (95% CI; 6.8%?18.4%).
Conclusions: The majority of COVID-19 patients with GIB responded to conservative management, with a low mortality rate associated with GIB and the risk of rebleeding. Thus, we suggest limiting endoscopic and IR interventions to those with hemodynamic instability and those for whom conservative management was unsuccessful.
Å°¿öµå
Acute gastrointestinal bleeding, COVID-19, Mortality, Novel Coronavirus, Rebleeding
¿ø¹® ¹× ¸µÅ©¾Æ¿ô Á¤º¸
µîÀçÀú³Î Á¤º¸
À¯È¿¼º°á°ú(Recomendation)
The majority of COVID-19 patients with GIB responded to conservative management, with a low mortality rate associated with GIB and the risk of rebleeding.