Management of upper gastrointestinal bleeding in patients with SARS-COV-2 infection in a hospital in Lima-Peru
DOI:
https://doi.org/10.22516/25007440.742Keywords:
SARS-CoV-2, Treatment, Endoscopy, Gastrointestinal bleedingAbstract
Introduction: The SARS-CoV-2 pandemic has led to the restructuring of digestive endoscopy units around the world, limiting endoscopic procedures and prioritizing emergency indications such as upper gastrointestinal hemorrhage (UGH). However, there is little evidence regarding its impact on evolution and outcomes.
Objective: To evaluate the management of UGH in the context of the SARS-CoV-2 coronavirus pandemic.
Materials and methods: Observational, descriptive, retrospective study carried out between March and August 2020 in patients with diagnosis of UGH and SARS-CoV-2 infection.
Results: Of 4 320 patients with SARS-CoV-2 infection, 51 had UGH on admission. The median age of the population was 70 years and 58.8% were male. Glasgow-Blatchford Bleeding Score (GBS) of ≥12 was obtained in 56.9%. Oxygen support was required by 21.6%. 34 (66.7%) patients received medical treatment only, while 17 (33.3%) received medical treatment plus upper gastrointestinal endoscopy (UGE), of which 6 (35.3%) underwent therapeutic endoscopy. Peptic ulcer disease was the most frequent finding. When comparing the type of treatment received, there were no significant differences between the number of red blood cell transfusions, rebleeding, re-admission due to UGH, hospital stay, or mortality secondary to UGH. Overall mortality was 25.4% (13 patients), mainly due to respiratory failure due to SARS-CoV-2.
Conclusions: A reduction in the number of emergency upper gastrointestinal endoscopies for UGH was observed during the current pandemic, as well as a longer than standard time for their performance. More than 80% of patients who received medical treatment alone evolved favorably and only one third of the patients who underwent UGE required endoscopic therapy.
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