PMID- 36397007
OWN - NLM
STAT- MEDLINE
DCOM- 20221121
LR  - 20221121
IS  - 1471-230X (Electronic)
IS  - 1471-230X (Linking)
VI  - 22
IP  - 1
DP  - 2022 Nov 17
TI  - Risk factors of active upper gastrointestinal bleeding in patients with COVID-19 
      infection and the effectiveness of PPI prophylaxis.
PG  - 465
LID - 10.1186/s12876-022-02568-4 [doi]
LID - 465
AB  - BACKGROUND: Gastrointestinal (GI) bleeding is one of the most impactful 
      complications in patients hospitalized from COVID-19 infection. Limited study has 
      focused on patients with upper GI bleeding (UGIB). This study aimed to identify 
      the risk factors of patients who were hospitalized from COVID-19 infection and 
      developed UGIB as well as the effectiveness of proton pump inhibitor (PPI) 
      prophylaxis in those patients. METHODS: This study was comprised of two phases. 
      The first phase was the retrospective enrollment of patients who were admitted 
      due to COVID-19 infection and developed UGIB between April and August 2021 to 
      evaluate the associated factors of active UGIB. The second phase was a 
      retrospective analysis after PPI prophylaxis protocol from September - October 
      2021 to assess the benefit of PPI use in those patients. RESULTS: Of 6,373 
      patients hospitalized, 43 patients (0.7%) had evidence of UGIB. The majority were 
      male 28 (65.1%) with a mean age of 69.1 +/- 11.8 years. Twenty-four of 43 patients 
      (55.8%) needed mechanical ventilation, 35 patients (81.4%) received systemic 
      corticosteroids, and 10 patients (23.3%) were taking anticoagulants for venous 
      thromboembolic prophylaxis. Seven of 43 patients (16%) had active UGIB. There was 
      no significant difference in the number of patients taking antiplatelets, 
      anticoagulants, or steroids and the severity of COVID-19 infection between the 
      two groups. An emergency endoscopy or endoscopic hemostasis were performed in 6/7 
      (85.7%) patients. The multivariate logistic regression analysis revealed two 
      significant factors associated with active UGIB including higher of 
      Glasgow-Blatchford score (GBS) per point (OR = 7.89; 95%CI 1.03-72.87; p = 0.04) 
      and an absence of PPI use (OR 4.29; 95%CI 1.04-19.51; p = 0.04). After 
      prescribing PPI as a prophylaxis, there was a slightly lower incidence of UGIB 
      (0.6% vs 0.7%) in addition to an absence of active UGIB (0% vs 16%). CONCLUSION: 
      Our study demonstrated that the absence of PPI and higher GBS were significant 
      risk factors for active UGIB which required therapeutic endoscopy in patients 
      with COVID-19 infection. We suggest that short-term PPI prophylaxis should be 
      prescribed in those patients once they need hospitalization regardless of the 
      severity of COVID-19 infection to minimize the severity of UGIB.
CI  - (c) 2022. The Author(s).
FAU - Prasoppokakorn, Thaninee
AU  - Prasoppokakorn T
AD  - Division of Gastroenterology, Department of Medicine, Faculty of Medicine, 
      Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross 
      Society, 1873 Rama IV Road, Pathumwan, Bangkok, 10330, Thailand.
FAU - Kullavanijaya, Pinit
AU  - Kullavanijaya P
AD  - Division of Gastroenterology, Department of Medicine, Faculty of Medicine, 
      Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross 
      Society, 1873 Rama IV Road, Pathumwan, Bangkok, 10330, Thailand.
FAU - Pittayanon, Rapat
AU  - Pittayanon R
AD  - Division of Gastroenterology, Department of Medicine, Faculty of Medicine, 
      Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross 
      Society, 1873 Rama IV Road, Pathumwan, Bangkok, 10330, Thailand. 
      rapat125@gmail.com.
LA  - eng
PT  - Journal Article
DEP - 20221117
PL  - England
TA  - BMC Gastroenterol
JT  - BMC gastroenterology
JID - 100968547
RN  - 0 (Proton Pump Inhibitors)
RN  - 0 (Anticoagulants)
SB  - IM
MH  - Humans
MH  - Male
MH  - Female
MH  - Middle Aged
MH  - Aged
MH  - Aged, 80 and over
MH  - *Proton Pump Inhibitors/therapeutic use
MH  - Retrospective Studies
MH  - *COVID-19/complications
MH  - Gastrointestinal Hemorrhage/chemically induced/prevention & control
MH  - Risk Factors
MH  - Endoscopy, Gastrointestinal/adverse effects
MH  - Anticoagulants/adverse effects
PMC - PMC9669529
OTO - NOTNLM
OT  - COVID-2019
OT  - Coronavirus-2019
OT  - Gastrointestinal bleeding
OT  - Gastrointestinal hemorrhage
OT  - SARS-CoV-2
COIS- The authors declare that they have no competing interests.
EDAT- 2022/11/19 06:00
MHDA- 2022/11/22 06:00
PMCR- 2022/11/17
CRDT- 2022/11/18 00:07
PHST- 2022/06/22 00:00 [received]
PHST- 2022/11/07 00:00 [accepted]
PHST- 2022/11/18 00:07 [entrez]
PHST- 2022/11/19 06:00 [pubmed]
PHST- 2022/11/22 06:00 [medline]
PHST- 2022/11/17 00:00 [pmc-release]
AID - 10.1186/s12876-022-02568-4 [pii]
AID - 2568 [pii]
AID - 10.1186/s12876-022-02568-4 [doi]
PST - epublish
SO  - BMC Gastroenterol. 2022 Nov 17;22(1):465. doi: 10.1186/s12876-022-02568-4.