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Dig Dis Sci ; 65(8): 2181-2186, 2020 08.
Artículo en Inglés | MEDLINE | ID: covidwho-598781


Coronavirus disease of 2019 (COVID-19) can be associated with high morbidity and mortality; patients with severe clinical manifestations may develop significant coagulopathy as well as unexpected thromboembolic complications. In response, centers are increasingly treating selected patients with intermediate-dose prophylactic or even therapeutic dose anticoagulation in order to prevent potentially catastrophic thrombotic complications. With this changing practice, the authors suspect that inpatient gastrointestinal consult teams across the country will be frequently managing COVID-19 patients with gastrointestinal bleeding (GIB). In order to reduce potentially avoidable hospital readmissions for GIB while improving patient outcomes, it is imperative to appropriately risk-stratify patients prior to initiation of anticoagulation. In this review, we discuss how to appropriately identify high-risk patients for GIB and how to mitigate GIB risk with proton-pump inhibitor co-therapy, medication reconciliation, and Helicobacter pylori testing and treating in this complex and morbid population.

Anticoagulantes/efectos adversos , Trastornos de la Coagulación Sanguínea , Infecciones por Coronavirus/sangre , Hemorragia Gastrointestinal , Neumonía Viral/sangre , Inhibidores de la Bomba de Protones/uso terapéutico , Ajuste de Riesgo/métodos , Anticoagulantes/administración & dosificación , Betacoronavirus/aislamiento & purificación , Trastornos de la Coagulación Sanguínea/prevención & control , Trastornos de la Coagulación Sanguínea/virología , Quimioprevención/métodos , Quimioprevención/normas , Hemorragia Gastrointestinal/inducido químicamente , Hemorragia Gastrointestinal/prevención & control , Humanos , Pandemias
Am J Gastroenterol ; 115(8): 1283-1285, 2020 08.
Artículo en Inglés | MEDLINE | ID: covidwho-590075


Gastrointestinal symptoms are common and frequently reported in Coronavirus Disease-2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It is unclear if SARS-CoV-2 is associated with increased risk of gastrointestinal bleeding (GIB). Nevertheless, GIB in COVID-19 patients poses unique challenges to patients due to high-risk of concomitant respiratory failure and to endoscopy personnel due to risk of airborne transmission during endoscopic procedures. Many management issues related to COVID-19 are still being studied. In this case series, we attempt to discuss the important clinical implications related to the management of GIB in COVID-19 patients.

Anemia/terapia , Infecciones por Coronavirus/terapia , Hemorragia Gastrointestinal/terapia , Neumonía Viral/terapia , Anciano de 80 o más Años , Anastomosis en-Y de Roux , Anemia/etiología , Betacoronavirus , Tratamiento Conservador , Infecciones por Coronavirus/complicaciones , Transfusión de Eritrocitos , Femenino , Hemorragia Gastrointestinal/complicaciones , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Úlcera Péptica Hemorrágica/complicaciones , Úlcera Péptica Hemorrágica/terapia , Neumonía Viral/complicaciones , Complicaciones Posoperatorias/terapia , Inhibidores de la Bomba de Protones/uso terapéutico , Índice de Severidad de la Enfermedad , Úlcera/complicaciones , Úlcera/terapia