Shafieipour Sara, Rezaei Zadeh Rukerd Mohammad, Farsiu Niloofar, Nakhaie Mohsen, Jahangiri Samaneh, Yousefi Maysam, Mirkamali Hanieh, Mohamadinezhad Aryan
Gastroenterology and Hepatology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran.
Clinical Research Development Unit, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran.
Middle East J Dig Dis. 2025 Jan;17(1):25-30. doi: 10.34172/mejdd.2025.406. Epub 2025 Jan 31.
COVID-19-associated gastrointestinal (GI) symptoms are often self-limiting; however, gastrointestinal bleeding (GIB) is a critical complication in patients with COVID-19. The present study investigates the etiology, risk factors, esophagogastroduodenoscopy (EGD) findings, and outcomes associated with upper gastrointestinal bleeding (UGIB) in hospital inpatients with COVID-19.
In this retrospective case-control study, 127 patients with COVID-19 in Kerman, Iran, were diagnosed using reverse transcription polymerase chain reaction (RT-PCR) and subsequently divided into case and control groups from January 2022 to July 2022.
This study evaluated 64 patients with COVID-19 with UGIB and 63 patients without. The case group reported previous history of GIB and cirrhosis at 17.2% and 12.5%, respectively (=0.001 and =0.01). Melena (37.5%) and peptic ulcer (21.87%) were the most common UGIB symptom and EGD findings, respectively. In the comparison of the case group with the control group, the duration of the patient's stay in the intensive care unit (ICU) (11.58±1.13 vs. 8.29±1.06 days), the need for invasive mechanical ventilation (IMV) (17.2% vs. 8.1%), and the mortality rate (26.6% vs. 18.9%) were recorded (=0.03, 0.124, and 0.07, respectively).
Patients with COVID-19 and UGIB have a more prevalent ICU stay compared with those without. Melena and peptic ulcer were the most common presentations and EGD findings in these patients. Additionally, liver cirrhosis and a history of previous GIB increased the risk of GIB in patients with COVID-19.
新型冠状病毒肺炎（COVID-19）相关的胃肠道（GI）症状通常为自限性；然而，胃肠道出血（GIB）是COVID-19患者的一种严重并发症。本研究调查了COVID-19住院患者上消化道出血（UGIB）的病因、危险因素、食管胃十二指肠镜检查（EGD）结果及相关结局。
在这项回顾性病例对照研究中，2022年1月至2022年7月，伊朗克尔曼的127例COVID-19患者采用逆转录聚合酶链反应（RT-PCR）进行诊断，随后分为病例组和对照组。
本研究评估了64例发生UGIB的COVID-19患者和63例未发生UGIB的患者。病例组中既往有GIB病史和肝硬化的患者分别占17.2%和12.5%（P=0.001和P=0.01）。黑便（37.5%）和消化性溃疡（21.87%）分别是最常见的UGIB症状和EGD检查结果。病例组与对照组比较，患者在重症监护病房（ICU）的住院时间（11.58±1.13天 vs. 8.29±1.06天）、有创机械通气（IMV）需求（17.2% vs. 8.1%）和死亡率（26.6% vs. 18.9%）有记录（P分别为0.03、0.124和0.07）。
与未发生UGIB的COVID-19患者相比，发生UGIB的患者在ICU的住院时间更普遍。黑便和消化性溃疡是这些患者最常见的表现和EGD检查结果。此外，肝硬化和既往GIB病史增加了COVID-19患者发生GIB的风险。
