Observed risk of recurrent bleeding and thromboembolic disease in COVID-19 patients with gastrointestinal bleeding.
Endosc Int Open
; 9(9): E1435-E1444, 2021 Sep.
Article
in English
| MEDLINE | ID: covidwho-1377929
ABSTRACT
Background and study aim COVID-19 patients are at increased risk for venous thromboembolism (VTE) requiring the use of anticoagulation. Gastrointestinal bleeding (GIB) is increasingly being reported, complicating the decision to initiate or resume anticoagulation as providers balance the risk of thrombotic disease with the risk of bleeding. Our study aimed to assess rebleeding rates in COVID-19 patients with GIB and determine whether endoscopy reduces these rebleeding events. We also report 30-day VTE and mortality rates. Methods This was a retrospective study evaluating 56 COVID-19 patients with GIB for the following outcomes:
30-day rebleeding rate, 30-day VTE rate, effects of endoscopic intervention on the rate of rebleeding, and 30-day mortality. Results The overall rates of VTE and rebleeding events were 27â% and 41â%, respectively. Rebleeding rates in patients managed conservatively was 42â% compared with 40â% in the endoscopy group.âOverall, 87â% of those who underwent invasive intervention resumed anticoagulation vs. 55â% of those managed medically ( P â=â0.02). The all-cause 30-day mortality and GIB-related deaths were 32â% and 9â%, respectively. Mortality rates between the endoscopic and conservative management groups were not statistically different (25â% vs. 39â%; P â=â0.30). Conclusions Although rebleeding rates were similar between the endoscopic and conservative management groups, patients who underwent intervention were more likely to restart anticoagulation. While endoscopy appeared to limit the duration that anticoagulation was withheld, larger studies are needed to further characterize its direct effect on mortality outcomes in these complex patients.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Type of study:
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Language:
English
Journal:
Endosc Int Open
Year:
2021
Document Type:
Article
Affiliation country:
A-1497-1801
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