PPIs and Beyond: A Framework for Managing Anticoagulation-Related Gastrointestinal Bleeding in the Era of COVID-19.
Dig Dis Sci
; 65(8): 2181-2186, 2020 08.
Article
in English
| MEDLINE | ID: covidwho-598781
ABSTRACT
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.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumonia, Viral
/
Blood Coagulation Disorders
/
Coronavirus Infections
/
Risk Adjustment
/
Proton Pump Inhibitors
/
Gastrointestinal Hemorrhage
/
Anticoagulants
Type of study:
Observational study
/
Prognostic study
Limits:
Humans
Language:
English
Journal:
Dig Dis Sci
Year:
2020
Document Type:
Article
Affiliation country:
S10620-020-06408-x
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