From the, Institute of Health Innovations and Outcomes Research, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA.
Division of Gastroenterology, Long Island Jewish Medical Center Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, New Hyde Park, NY, USA.
J Intern Med. 2021 Jun;289(6):887-894. doi: 10.1111/joim.13232. Epub 2021 Jan 29.
Gastrointestinal (GI) bleeding has been observed amongst patients hospitalized with COVID-19. Recently, anticoagulation has shown to decrease mortality, but it is unclear whether this contributes to increased GI bleeding. The aims of this study are: (i) to examine whether there are risk factors for GI bleeding in COVID-19 patients and (ii) to study whether there is a mortality difference between hospitalized patients with COVID-19 with and without GI bleeding.
This is a propensity score matched case-control study from a large health system in the New York metropolitan area between March 1st and April 27th. COVID-19 patients with GI bleeding were matched 1:1 to COVID-19 patients without bleeding using a propensity score that took into account comorbidities, demographics, GI bleeding risk factors and length of stay.
Of 11, 158 hospitalized with COVID-19, 314 patients were identified with GI bleeding. The point prevalence of GI bleeding was 3%. There were no identifiable risk factors for GI bleeding. Use of anticoagulation medication or antiplatelet agents was not associated with increased risk of GI bleeding in COVID-19 patients. For patients who developed a GI bleed during the hospitalization, there was an increased mortality risk in the GI bleeding group (OR 1.58, P = 0.02).
Use of anticoagulation or antiplatelet agents was not risk factors for GI bleeding in a large cohort of hospitalized COVID-19 patients. Those with GI bleeding during the hospitalization had increased mortality.
在因 COVID-19 住院的患者中观察到胃肠道（GI）出血。最近，抗凝治疗已显示可降低死亡率，但尚不清楚这是否会导致 GI 出血增加。本研究的目的是：（i）检查 COVID-19 患者是否存在 GI 出血的危险因素，（ii）研究 COVID-19 合并和不合并 GI 出血的住院患者之间是否存在死亡率差异。
这是一项来自纽约大都市区一个大型医疗系统的倾向评分匹配病例对照研究，研究时间为 3 月 1 日至 4 月 27 日。使用考虑了合并症、人口统计学、GI 出血危险因素和住院时间的倾向评分，将 COVID-19 伴 GI 出血的患者与 COVID-19 无出血的患者进行 1:1 匹配。
在 11158 例因 COVID-19 住院的患者中，有 314 例患者被诊断为 GI 出血。GI 出血的时点患病率为 3%。未发现 GI 出血的可识别危险因素。COVID-19 患者使用抗凝药物或抗血小板药物与 GI 出血风险增加无关。对于在住院期间发生 GI 出血的患者，GI 出血组的死亡率风险增加（OR 1.58，P=0.02）。
在大型 COVID-19 住院患者队列中，使用抗凝或抗血小板药物不是 GI 出血的危险因素。在住院期间发生 GI 出血的患者死亡率增加。
