Gastrointestinal bleeding as an extrapulmonary effect of COVID-19 infection
Hammurabi Medical College, University of Babylon, Babylon, Iraq
Hammurabi Medical College, University of Babylon, Babylon, Iraq
Hammurabi Medical College, University of Babylon, Babylon, Iraq
Hammurabi Medical College, University of Babylon, Babylon, Iraq
Abstract
Background: Coronavirus disease 2019 (COVID-19) is a worldwide pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which appear in Wuhan, Hubei Province, China, in late December 2019. On March 11, 2020, World Health Organization (WHO) considered it a global pandemic. Although pneumonia is the most common presentation of COVID-19, GIT is regarded as the most common site for the extrapulmonary manifestation of COVID-19 which includes vomiting, nausea, diarrhea, abdominal pain, and gastrointestinal (GI) hemorrhage. In covid-19, GI bleeding can result from multiple factors, isolated or combined This study aimed to evaluate GI bleeding as an extrapulmonary complication among patients with COVID-19 infection. Materials and methods: This study is completed in Merjan Medical City, Babylon, Iraq. So the mild cases of COVID-19 that do not need hospital admission are excluded from this study. It was a retrospective observational study that included a sample of 1106 inpatients who have been admitted from June 2020 to March 2021. The population of the study includes every admitted patient who has been diagnosed with COVID-19 by PCR and/or Chest CT scan. Other investigations used in this study include CBC, CRP, serum creatinine, and blood urea. Results: Melena was the commonest type of GI bleeding and diabetes was the commonest comorbidity. Comorbidities and positive CRP have existed in most patients with GI bleeding. Platelet count and PCV are significantly lower in cases of COVID-19 with GI bleeding. There was a significant association between plasma, Favipiravir, Remdesivir, Methylprednisolone, and unfractionated heparin and GIT bleeding. Unfortunately, RCU admission and mortality are the increase in all types of GI bleeding. Conclusion: Melena was the commonest type of GI bleeding, although all types of GI bleeding were seen in COVID-19 infection. The major risk factors for GI bleeding were: older age, lower SOP2, higher CT involvement, associated co-morbidities, and lower platelets count. The use of certain treatments like convalescent plasma, Remdesivir, and pulse methylprednisolone was associated with an increased risk of bleeding in a patient with COVID-19 infection.
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