Sanzone Erin, Gheysens Katherine, Hunter Krystal, Chaaya Adib, Phadtare Sangita
Cooper Medical School of Rowan University, Camden, New Jersey, USA.
Department of Gastroenterology, Virtua Gastroenterology, Cherry Hill, New Jersey, USA.
Gastroenterol Res Pract. 2025 Mar 31;2025:4358786. doi: 10.1155/grp/4358786. eCollection 2025.
In March 2020, the severe acute respiratory distress syndrome coronavirus 2 (COVID-19) became a worldwide pandemic. Recently, it has been shown that direct entry of this virus in the gastrointestinal (GI) epithelial cells causes tissue damage and the use of anticoagulants increases the risk of GI bleeding. These pose real concerns for the gastroenterologists concerning the mortality, overall incidence, and management of upper GI bleeding in SARS-CoV-2-positive patients. This retrospective study includes patients 18 years or older admitted to our health system with an upper GI bleed (UGB). Patients with possible UGB, endoscopy, and SARS-CoV-2-positive testing ( = 587) formed the initial cohort. In-depth data were collected for symptoms, medications, source of bleeding, and interventions for subsets of test and control subjects. Duodenal ulcer was the most common etiology for GI bleeding in SARS-CoV-2-positive patients, while esophagitis was the most common etiology in control subjects. SARS-CoV-2-positive patients had significant progressive anemia and had to be given more blood transfusions, steroids, proton pump inhibitors, and immunosuppressants. In-hospital mortality was greater in the experimental group (12.8%) than in the control group (5.1%). Furthermore, the SARS-CoV-2-positive patients had more therapeutic interventions compared to the SARS-CoV-2-negative patients. Nearly one-quarter of all patients had an endoscopy over 48 h after bleeding was observed. Healthcare providers should be aware of the greater therapeutic needs of SARS-CoV-2-positive patients with UGB. Our data helps shed light on the relationship between SARS-CoV-2 and GI bleeding due to SARS-CoV-2-related tissue damage and treatment affecting the GI tract.
2020年3月，严重急性呼吸综合征冠状病毒2（COVID-19）成为全球大流行病。最近有研究表明，这种病毒直接进入胃肠道（GI）上皮细胞会导致组织损伤，而使用抗凝剂会增加胃肠道出血的风险。这些情况让胃肠病学家着实担忧SARS-CoV-2阳性患者上消化道出血的死亡率、总体发病率及治疗。这项回顾性研究纳入了我们医疗系统中因上消化道出血（UGB）入院的18岁及以上患者。可能患有UGB、接受过内镜检查且SARS-CoV-2检测呈阳性（n = 587）的患者构成了初始队列。针对检测组和对照组亚组的症状、用药、出血来源及干预措施收集了详细数据。十二指肠溃疡是SARS-CoV-2阳性患者胃肠道出血最常见的病因，而食管炎是对照组最常见的病因。SARS-CoV-2阳性患者有明显的进行性贫血，不得不接受更多的输血、使用类固醇、质子泵抑制剂和免疫抑制剂。实验组的住院死亡率（12.8%）高于对照组（5.1%）。此外，与SARS-CoV-2阴性患者相比，SARS-CoV-2阳性患者接受了更多的治疗干预。在所有患者中，近四分之一在观察到出血后48小时以上才接受内镜检查。医疗服务提供者应意识到SARS-CoV-2阳性UGB患者有更大的治疗需求。我们的数据有助于阐明SARS-CoV-2与因SARS-CoV-2相关组织损伤及影响胃肠道的治疗导致的胃肠道出血之间的关系。
