Examining the frequency of endoscopic findings in patients with covid-19 with upper gastrointestinal bleeding referred to al-Zahra Hospital of Isfahan.

Background: Gastrointestinal bleeding is one of the consequences of COVID-19, which is associated with increased hospitalization and patient mortality. This study was conducted to determine the prevalence of endoscopic findings and the outcome of gastrointestinal bleeding in patients with COVID-19 who were hospitalized from September to December 2019 in Al-Zahra Hospital, Isfahan. Method(s): In this cross-sectional study, out of 5800 patients who were admitted to Al-Zahra Hospital in Isfahan from September to December 2019 due to COVID-19 (according to the positive PCR test result), 87 patients who underwent endoscopy due to upper gastrointestinal bleeding by a skilled gastroenterologist, were selected and studied. Demographic characteristics, underlying diseases, use of anticoagulants, and laboratory findings were studied and evaluated and finally, the disease was evaluated and compared based on endoscopic findings. Result(s): Based on the results obtained from this research, the patients with endoscopic lesions had higher average age (P=0.041), lower blood oxygen saturation percentage (P=0.028), and higher bleeding intensity (P=0.018). The frequency of using anticoagulant drugs in the group whose endoscopy results were abnormal was higher but insignificant. Hemoglobin, platelet, lymphocyte, and CRP levels were higher in the group whose endoscopy was normal, and NLR, LDH, and D-dimer levels were higher in the group whose endoscopy was abnormal (P<0.050). Three people (11.55%) from the group with normal endoscopy and 18 people (29.5%) from the group with abnormal endoscopy died, but the frequency of death was not significantly different between the two groups (P=0.070). Conclusion(s): The findings of the present study showed that the COVID patients with upper gastrointestinal bleeding who had endoscopic lesions had significant differences in some characteristics such as age, bleeding intensity, and blood oxygen saturation percentage with patients with normal endoscopy. Also, the frequency of death in patients with endoscopic lesions was relatively higher. Therefore, COVID patients with gastrointestinal bleeding should undergo endoscopy as soon as possible and necessary measures should be taken to control and prevent gastrointestinal bleeding.Copyright © 2022 Tabesh et al. Tehran University of Medical Sciences. Published by Tehran University of Medical Sciences.

Examining the frequency of endoscopic findings in patients with COVID-19 with upper gastrointestinal bleeding referred to al-Zahra Hospital of Isfahan

Background: Gastrointestinal bleeding is one of the consequences of COVID-19, which is associated with increased hospitalization and patient mortality. This study was conducted to determine the prevalence of endoscopic findings and the outcome of gastrointestinal bleeding in patients with COVID-19 who were hospitalized from September to December 2019 in Al-Zahra Hospital, Isfahan. Methods: In this cross-sectional study, out of 5800 patients who were admitted to Al- Zahra Hospital in Isfahan from September to December 2019 due to COVID-19 (according to the positive PCR test result), 87 patients who underwent endoscopy due to upper gastrointestinal bleeding by a skilled gastroenterologist, were selected and studied. Demographic characteristics, underlying diseases, use of anticoagulants, and laboratory findings were studied and evaluated and finally, the disease was evaluated and compared based on endoscopic findings. Results: Based on the results obtained from this research, the patients with endoscopic lesions had higher average age (P=0.041), lower blood oxygen saturation percentage (P=0.028), and higher bleeding intensity (P=0.018). The frequency of using anticoagulant drugs in the group whose endoscopy results were abnormal was higher but insignificant. Hemoglobin, platelet, lymphocyte, and CRP levels were higher in the group whose endoscopy was normal, and NLR, LDH, and D-dimer levels were higher in the group whose endoscopy was abnormal (P<0.050). Three people (11.55%) from the group with normal endoscopy and 18 people (29.5%) from the group with abnormal endoscopy died, but the frequency of death was not significantly different between the two groups (P=0.070). Conclusion: The findings of the present study showed that the COVID patients with upper gastrointestinal bleeding who had endoscopic lesions had significant differences in some characteristics such as age, bleeding intensity, and blood oxygen saturation percentage with patients with normal endoscopy. Also, the frequency of death in patients with endoscopic lesions was relatively higher. Therefore, COVID patients with gastrointestinal bleeding should undergo endoscopy as soon as possible and necessary measures should be taken to control and prevent gastrointestinal bleeding.

The effect of vitamin E and vitamin C in patients with COVID-19 pneumonia;a randomized controlled clinical trial

Introduction: Cytokine storm and oxidative stress play a key role in the pathogenesis of coronavirus disease 2019 (COVID-19). Vitamins C and E are two known antioxidants with possible theoretical beneficial effects in COVID-19 patients. Objectives: This study aimed to clinically evaluate the effects of the combination of these agents as adjunctive therapy with the standard treatment in the outcome of COVID-19 patients. Patients and Methods: Hospitalized non-severe COVID-19 patients were randomly divided into two groups of intervention (n=38) and control (n=34) to receive either oral vitamin C 1000 mg daily plus oral vitamin E 400 IU daily in addition to the national standard treatment regimen (hydroxychloroquine) or standard regimen alone, respectively, during the hospitalization period until hospital discharge or ICU admission. The clinical response of patients at the end of treatment (either cure, improvement, or failure), the duration of hospitalization, and the mortality rate were recorded and compared between the groups. Results: During the study, three patients in the intervention group (7.89%) and five patients in the control group (14.71%) had treatment failure, while all other patients had clinical improvement (P = 0.380). The duration of hospitalization was shorter in the intervention group (7.95 +/- 3.18 days) compared to the control group (8.03 +/- 2.83 days);however, the difference was not statistically significant (P = 0.821). Furthermore, no patients in both groups died during the study. Conclusion: The combination of oral vitamins C (1000 mg daily) and E (400 IU daily) has no beneficial effect in COVID-19 patients.