Clinical analysis of gastrointestinal bleeding in patients with severe coronavirus disease (COVID-19): A retrospective observational study (preprint)

ABSTRACT

Background: The epidemic of Novel coronavirus disease 2019(COVID-19) has attracted the great attention of people all over the world. Gastrointestinal bleeding in patients with COVID-19 has been studied rarely. We mean to investigate the clinical characteristics of gastrointestinal bleeding in patients with severe coronavirus disease (COVID-19).Methods: Nineteen severe COVID-19 patients with gastrointestinal bleeding were retrospectively studied. Clinical data, including medical history, symptoms, laboratory characteristics, and treatment, were collected and analyzed. We also compared the characteristics of patients with different degrees of bleeding.Results: Fourteen patients (73.6%) were men. Mean age was 63.8 (±15.6) years. Most patients (89.4%) had no history of gastrointestinal bleeding. The most common presentation of gastrointestinal bleeding was a positive fecal occult blood test (15/19 cases, 78.9%). Fifteen patients (78.9%) did not require blood transfusion. Five of 15 patients (33%) received anticoagulants and antiplatelet drugs before gastrointestinal bleeding in the mild bleeding group, and 2/4 (50%) in the severe bleeding group. Four of 15 patients (27%) died in the mild bleeding group and no patients died in the severe bleeding group.Conclusions: The presentations of gastrointestinal bleeding in severe COVID-19 patients are not obvious, and frequent fecal occult blood test is needed to detect gastrointestinal bleeding early. Patients receiving anticoagulants and antiplatelet drugs need a close observation for gastrointestinal bleeding. Gastrointestinal bleeding may not increase the mortality, after giving blood transfusion support therapy.