Lui Thomas K L, Tsui Vivien W M, Leung Wai K
Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China.
Endosc Int Open. 2021 Mar;9(3):E284-E288. doi: 10.1055/a-1333-1337. Epub 2021 Feb 18.
The COVID-19 pandemic has caused a major disruption in the healthcare system. This study determined the impact of the first wave of COVID-19 on the number and outcome of patients hospitalized for upper gastrointestinal bleeding (UGIB) in Hong Kong. Records of all patients hospitalized for UGIB in Hong Kong public hospitals between October 2018 and June 2020 were retrieved. The number and characteristics of patients hospitalized for UGIB after COVID-19 was compared by autoregressive integrated moving average (ARIMA) model prediction and historical cohort. Since the first local case of COVID-19, there was an initial drop in UGIB hospitalizations (observed 29.8 vs predicted 35.5 per week; = 0.05) followed by a rebound (39.8 vs 26.7 per week; < 0.01) with a turning point at week 14 (Petitt's test, < 0.001). There was a negative association between the number of COVID-19 cases and the number of patients hospitalized for UGIB (Pearson correlation -0.53, < 0.001). Patients admitted after the outbreak of COVID-19 had lower hemoglobin (7.5 vs baseline 8.3 g/dL; < 0.01) and a greater need for blood transfusion (64.5 % vs baseline 50.4 %; < 0.01), but similar rates of all-cause mortality (6.9 % vs 7.1 %; = 0.82) and rebleeding (6.7 % vs 5.1 %; = 0.11). There was also a higher proportion of patients with variceal bleeding (10.5 % vs baseline 5.3 %; < 0 .01). There was a dynamic change in the number of patients hospitalized for UGIB in Hong Kong during the first wave of the COVID-19 outbreak, with more obvious impact during the initial phase only.
新冠疫情给医疗系统带来了重大干扰。本研究确定了新冠疫情第一波对香港因上消化道出血（UGIB）住院患者数量及治疗结果的影响。检索了2018年10月至2020年6月期间香港公立医院所有因UGIB住院患者的记录。采用自回归积分移动平均（ARIMA）模型预测和历史队列比较了新冠疫情后因UGIB住院患者的数量和特征。自香港首例新冠本地病例出现以来，UGIB住院人数最初有所下降（观察到每周29.8例，预测为每周35.5例；P = 0.05），随后出现反弹（每周39.8例，预测为每周26.7例；P < 0.01），转折点在第14周（佩蒂特检验，P < 0.001）。新冠病例数与因UGIB住院患者数之间存在负相关（皮尔逊相关系数为 -0.53，P < 0.001）。新冠疫情爆发后入院的患者血红蛋白水平较低（7.5 g/dL，而基线为8.3 g/dL；P < 0.01），输血需求更大（64.5%，而基线为50.4%；P < 0.01），但全因死亡率（6.9% 对7.1%；P = 0.82）和再出血率（6.7% 对5.1%；P = 0.11）相似。静脉曲张出血患者的比例也更高（10.5%，而基线为5.3%；P < 0.01）。在新冠疫情第一波爆发期间，香港因UGIB住院的患者数量有动态变化，仅在初始阶段影响更为明显。
