Endoscopy 2021; 53(S 01): S267
DOI: 10.1055/s-0041-1724998
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Gastrointestinal Bleeding In Covid-19 Patients: A Systematic Review And Meta-Analysis

G Marasco
1   University of Bologna, Department of Medical and Surgical Science, Bologna, Italy
,
M Maida
2   Gastroenterology and Endoscopy Unit, S. Elia-Raimondi Hospital, Caltanissetta, Italy
,
GC Morreale
2   Gastroenterology and Endoscopy Unit, S. Elia-Raimondi Hospital, Caltanissetta, Italy
,
M Licata
2   Gastroenterology and Endoscopy Unit, S. Elia-Raimondi Hospital, Caltanissetta, Italy
,
C Cremon
1   University of Bologna, Department of Medical and Surgical Science, Bologna, Italy
,
V Stanghellini
1   University of Bologna, Department of Medical and Surgical Science, Bologna, Italy
,
G Barbara
1   University of Bologna, Department of Medical and Surgical Science, Bologna, Italy
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    Aims The novel SARS-CoV-2 disease (COVID-19) has been reported to affect the gastrointestinal (GI) system with a wide variety of symptoms, including GI bleeding. The aim of this meta-analysis is to estimate the rate of GI bleeding of patients infected with SARS-CoV-2.

    Methods MEDLINE via PubMed, Ovid Embase, Scopus and Cochrane Library were systematically searched through October, 10th 2020. Studies simultaneously reporting cohorts of COVID-19 patients with and without GI bleeding were included. A random-effect model was applied for pooling results; heterogeneity was expressed as I2. Impact of confounding covariates on the meta-analytic results was evaluated using meta-regression analysis.

    Results Seven studies (including a total of 1047 COVID-19 patients) met the inclusion criteria and were included in the analysis.

    Among COVID-19 patients with gastrointestinal bleeding, 93 experienced upper and 21 lower GI bleeding. The mean age of participants ranged from 45.3 to 73.7 years. Four studies have been carried out in Western countries (2 in the US, 1 in Italy and 1 in Israel), and 3 in Eastern countries (China). Three studies reported the rate of patients taking anticoagulants or antiplatelets, ranging from 37.4 % to 100 %. The overall pooled bleeding rate was 9 % [95 % CI: 2 % to 20 %], with high heterogeneity (I2 96.4 %), and no “small study effect” observed using the Egger test (p = 0.979). The pooled upper gastrointestinal bleeding rate was 7 % (95 % CI: 1 % to 17 %, I2 95.3 %, Egger test p = 0.835), whereas the pooled lower gastrointestinal bleeding rate was 1 % (95 % CI: 0 % to 4 %, I2 82.4 %, Egger test p = 0.437). Meta-regression analysis showed that overall risk bleeding was significantly affected by the geographic area of the study (β 0.899±0.027) and the upper source of bleeding (β 1.010±0.003).

    Conclusions In this meta-analysis of published studies, individuals with SARS-CoV-2 infections were found to be at risk for GI bleeding, especially upper GI bleeding.

    Citation Marasco G, Maida M, Morreale GC et al. eP509 GASTROINTESTINAL BLEEDING IN COVID-19 PATIENTS: A SYSTEMATIC REVIEW AND META-ANALYSIS. Endoscopy 2021; 53: S267.


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    Publication History

    Article published online:
    19 March 2021

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