A case series on upper GI bleeding among patients admitted with COVID-19 infection

Abstract

Background: Patients with COVID-19 infection are liable to develop coagulopathies and bleeding. An increase in the use of anticoagulants among this group of patients may be associated with an increase in the risk of developing GI bleeding. We aimed to evaluate the endoscopic characteristics of patients with COVID-19 that developed a GI bleed.

Methods: A retrospective analysis of patients admitted to Rashid hospital with Upper GI bleeding, and COVID was done. We collected details on patient demographics, comorbid conditions, the severity of COVID infection, use of antiplatelet/anticoagulants, and their endoscopic findings.

Results: 14 cases of Upper GI bleeding were included, half of which were on antiplatelet/anticoagulant. Endoscopic findings included peptic ulcer disease, Mallory Weis, gastritis, dieulafouy lesion, esophageal varices, and small gastric erosions. Peptic ulcer disease was the most common finding on endoscopy.

Conclusion: Coagulopathy and bleeding risk remains a challenge in patients with COVID-19. Although peptic ulcer disease was the commonest etiology, it is still unclear whether the risk of bleeding was secondary to COVID-19 infection itself or the use of anticoagulants. We recommend physicians to be cognizant of the possible endoscopic features that may be encountered in COVID-19 infected patients presenting with GI bleeding so as to provide optimal management.