ABSTRACT
Introduction-The Coronavirus Disease-2019 (COVID-19) caused by the novel severe acuterespiratory syndrome coronavirus-2 (SARS-CoV-2) led to significant strain on healthcaresystems worldwide. The decline in UGIB-related hospitalizations is thought to be related tothe fear of contracting the virus and failure of the patients to seek medical care. It is unclearif UGIB-related hospitalizations have been reduced in the US during the pandemic.Methods-We utilized a federated cloud-based network (TriNetX), which provides accessto electronic medical records from 92 healthcare organizations (HCOs) from the US. TheUGIB patients hospitalized from January 1, 2020, to December 1, 2020, were compared toa similar timeline in 2019 from the TriNetX database. Outcomes of the study includemortality rate, utilization rates of esophagogastroduodenoscopy (EGD), colonoscopy, andsigmoidoscopy. The outcomes were measured before and after 1:1 propensity matching ofthe groups based on the baseline demographics and comorbidities.Results-Prevalence of UGIB hospitalizations in 2020 was 27.84% (28,518 UGIB hospitalizationsamong 102,437 total hospitalizations), compared to 34.22% (110,327 UGIB hospitalizationsamong 322,405 total hospitalizations) in 2019. There was a significant decrease (6.4%) in the number of UGIB hospitalizations from pre-pandemic compared to pandemic times(P<0.001). However, the proportion of variceal bleeding and non-variceal bleeding amongthe UGIB population did not change in 2020 compared to 2019 (Table 1). Patients in the2020-group had lower mortality rate (RR 0.45, 95% CI: 0.42–0.47), decreased utilizationof EGD (RR 0.76, 95% CI: 0.74–0.78), colonoscopy (RR 0.71, 95% CI: 0.69–0.74) andsigmoidoscopy (RR 0.67, 95% CI, 0.59 – 0.76) (Table 2).Conclusion-A significant reduction (6.4%) of UGIB hospitalizations with no change in theproportion of variceal and non-variceal bleeding was seen in 2020 compared to 2019.Despite these changes, EGD utilization declined by 25% in 2020 compared to 2019 duringthe same months.AGA s(Figure Presented)Figure 1: Patient's characteristics an comorbidities before and after matching(Figure Presented)Figure 2: Laboratory values and outcomes of the patient admitted with upper gastrointestinal bleed
ABSTRACT
The entire World is going through hard times because of the emergence of new pandemic named Coronavirus or COVID-19. The virus originated from Wuhan and is spreading Worldwide. There are many questions arising regarding the origin of this fatal virus;whether it is natural or man-made. In the past years, many microorganisms were used as a bio-warfare agents for causing destruction. In 2001, anthrax attack took place in US by the use of bacteria, Bacillus anthracis which acted as a bioweapon and lead to number of deaths in Texas, US. This review summarises the origin, epidemiology, medico-legal aspectsand the recent researches of the virus indicating its nature of being manmade or a natural virus. © 2020, Institute of Medico-Legal Publications. All rights reserved.