Alessandra Negro, RN, is Head Nurse, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Giulia Villa, PhD, RN, is Assistant Professor in Nursing Science, Center for Nursing Research and Innovation, Vita-Salute San Raffaele University, Milan, Italy.
Gastroenterol Nurs. 2022;45(4):267-275. doi: 10.1097/SGA.0000000000000676. Epub 2022 Jul 13.
The incidence of COVID-19 gastrointestinal manifestations has been reported to range from 3% to 61%. There are limited data on the incidence rates and risk factors associated with gastrointestinal bleeding (GIB) in patients with COVID-19. A rapid review has been designed to investigate whether there is a relationship between COVID-19 and GIB in adult patients. PubMed, CINAHL, EMBASE, Cochrane Library, and Scopus databases have been analyzed. A total of 129 studies were found; 29 full texts were analyzed, and of these, 20 were found to be relevant to the topic. The key findings of the included studies present an overall GIB rate in COVID-19 patients ranging from 1.1% to 13%. The bleeding involves mucosal damage of the duodenum, stomach, colon, and rectum. The management of gastrointestinal bleeding could be conservative. The use of fecal diversion systems for the management of diarrhea in COVID-19 patients should be minimized and closely evaluated for the risk of rectal mucosal damages and erosions. It is recommended to provide an accurate nutritional assessment; an early setting up of enteral nutrition, if not contraindicated, can help protect the gut mucosa of patients and restore normal intestinal flora. Larger cohort studies are needed to increase the information about this topic.
COVID-19 胃肠道表现的发病率据报道为 3%至 61%。关于 COVID-19 患者胃肠道出血 (GIB) 的发病率和相关风险因素的数据有限。本快速综述旨在调查 COVID-19 是否与成人患者的 GIB 有关。分析了 PubMed、CINAHL、EMBASE、Cochrane 图书馆和 Scopus 数据库。共发现 129 项研究；分析了 29 篇全文，其中 20 篇与主题相关。纳入研究的主要发现显示 COVID-19 患者的总体 GIB 率为 1.1%至 13%。出血涉及十二指肠、胃、结肠和直肠的粘膜损伤。胃肠道出血的治疗可以是保守的。应尽量减少使用粪便分流系统来管理 COVID-19 患者的腹泻，并密切评估直肠粘膜损伤和糜烂的风险。建议提供准确的营养评估；如果没有禁忌症，尽早建立肠内营养可以帮助保护患者的肠道粘膜并恢复正常的肠道菌群。需要更大的队列研究来增加关于这个主题的信息。
