COVID-19 Severity is Associated with the Risk of Gastrointestinal Bleeding

Overview

Journal BMJ Open Gastroenterol

Specialty Gastroenterology

Date 2023 Nov 14

PMID 37963649

Authors

Shuji Hibiya

Takashi Fujii

Toshimitsu Fujii

Shinji Suzuki

Mayumi Kondo

Shinya Ooka

Yohei Furumoto

Seishin Azuma

Kei Tanaka

Hitoshi Kurata

Shohei Tanaka

Masayuki Kurosaki

Kazuyoshi Nagayama

Fumihiko Kusano

Yasuhiro Iizuka

Takahiro Kawamura

Hidekazu Ikemiyagi

Shinya Sakita

Tsunehito Yauchi

Hideki Watanabe

Ami Kawamoto

Yusuke Matsuyama

Kazuo Ohtsuka

Ryuichi Okamoto

Affiliations

Soon will be listed here.

Abstract

Objective: The association between the severity of COVID-19 and gastrointestinal (GI) bleeding is unknown. This study aimed to determine whether the severity of COVID-19 is a risk factor for GI bleeding.

Design: A multicentre, retrospective cohort study was conducted on hospitalised patients with COVID-19 between January 2020 and December 2021. The severity of COVID-19 was classified according to the National Institute of Health severity classification. The primary outcome was the occurrence of GI bleeding during hospitalisation. The main analysis compared the relationship between the severity of COVID-19 and the occurrence of GI bleeding. Multivariable logistic regression analysis was performed to evaluate the association between the severity of COVID-19 and the occurrence of GI bleeding.

Results: 12 044 patients were included. 4165 (34.6%) and 1257 (10.4%) patients had severe and critical COVID-19, respectively, and 55 (0.5%) experienced GI bleeding. Multivariable analysis showed that patients with severe COVID-19 had a significantly higher risk of GI bleeding than patients with non-severe COVID-19 (OR: 3.013, 95% CI: 1.222 to 7.427). Patients with critical COVID-19 also had a significantly higher risk of GI bleeding (OR: 15.632, 95% CI: 6.581 to 37.130). Patients with severe COVID-19 had a significantly increased risk of lower GI bleeding (OR: 10.349, 95% CI: 1.253 to 85.463), but the risk of upper GI bleeding was unchanged (OR: 1.875, 95% CI: 0.658 to 5.342).

Conclusion: The severity of COVID-19 is associated with GI bleeding, and especially lower GI bleeding was associated with the severity of COVID-19. Patients with severe or critical COVID-19 should be treated with caution as they are at higher risk for GI bleeding.

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