Gianfrate Gianmarino, Gillie Breanna, Renner Charles, Gruber Brian
General Surgery, St Elizabeth Youngstown Hospital, Youngstown, USA.
Vascular Surgery, University of Kentucky College of Medicine, Lexington, USA.
Cureus. 2025 Mar 26;17(3):e81241. doi: 10.7759/cureus.81241. eCollection 2025 Mar.
Gastrointestinal (GI) hemorrhage has been reported in patients with SARS-CoV-2. Although there is consensus that the infection is associated with GI sequelae, controversy remains regarding its clinical significance. Endoscopic intervention was limited during the pandemic due to safety concerns and resource constraints, which may have hindered a full assessment of the impact of GI hemorrhage on patient outcomes. This paper aims to evaluate the outcomes of patients diagnosed with SARS-CoV-2 and concurrent clinically significant GI hemorrhage.
A total of 125 patients (69 male, 56 female) over the age of 18, with signed procedural consent, were included. All met the criteria for a SARS-CoV-2 diagnosis and underwent diagnostic endoscopic intervention. Data were analyzed using the Mann-Whitney U test with Excel (Microsoft Corporation, Redmond, WA, USA) and SPSS Statistics version 25 (IBM Corp., Released 2017. IBM SPSS Statistics for Windows, Version 25.0. Armonk, NY: IBM Corp.).
The overall hospital length of stay was 8 ± 6 days. A subset analysis compared patients requiring ICU admission with those who did not. The average ICU length of stay was 13 ± 6 days, compared to 5 ± 3 days for non-ICU patients. Among patients who underwent esophagogastroduodenoscopy, 65% (70/108) required intervention, while 16% (3/19) of colonoscopies required intervention. There was no significant difference in underlying comorbidities or rates of non-invasive mechanical ventilation between groups. Overall mortality was 50% (62/125), with no significant difference between ICU (26/50) and non-ICU (36/75) patients (52% vs. 48%).
While studies have indicated an increased risk of GI complications in SARS-CoV-2 patients, many have not differentiated between hemorrhagic and non-hemorrhagic sequelae or accounted for the level of care. We conclude that there was higher mortality among patients requiring endoscopic intervention, regardless of their level of care or patient-specific factors.
新型冠状病毒肺炎（SARS-CoV-2）患者中已报告有胃肠道出血情况。尽管人们一致认为该感染与胃肠道后遗症有关，但其临床意义仍存在争议。在疫情期间，由于安全担忧和资源限制，内镜干预受到限制，这可能阻碍了对胃肠道出血对患者预后影响的全面评估。本文旨在评估诊断为SARS-CoV-2且并发具有临床意义的胃肠道出血患者的预后。
纳入125例年龄超过18岁且签署了手术同意书的患者（男性69例，女性56例）。所有患者均符合SARS-CoV-2诊断标准并接受了诊断性内镜干预。使用美国华盛顿州雷德蒙德市微软公司的Excel和IBM公司2017年发布的SPSS Statistics 25版软件（IBM SPSS Statistics for Windows，版本25.0。纽约州阿蒙克市：IBM公司）进行曼-惠特尼U检验分析数据。
患者的总体住院时间为8±6天。一项亚组分析比较了需要入住重症监护病房（ICU）的患者和不需要入住的患者。ICU患者的平均住院时间为13±6天，而非ICU患者为5±3天。在接受食管胃十二指肠镜检查的患者中，65%（70/108）需要干预，而结肠镜检查患者中有16%（3/19）需要干预。两组患者的基础合并症或无创机械通气率无显著差异。总体死亡率为50%（62/125），ICU患者（26/50）和非ICU患者（36/75）之间无显著差异（52%对48%）。
虽然研究表明SARS-CoV-2患者发生胃肠道并发症的风险增加，但许多研究并未区分出血性和非出血性后遗症，也未考虑护理水平。我们得出结论，无论护理水平或患者个体因素如何，需要内镜干预的患者死亡率更高。
