Gastrointestinal bleeding and endoscopic findings in critically and non-critically ill patients with corona virus disease 2019 (COVID-19): Results from Lean European Open Survey on SARS-CoV-2 (LEOSS) and COKA registries

the LEOSS Study Group

doi:10.1002/ueg2.12165

Gastrointestinal bleeding and endoscopic findings in critically and non-critically ill patients with corona virus disease 2019 (COVID-19): Results from Lean European Open Survey on SARS-CoV-2 (LEOSS) and COKA registries

the LEOSS Study Group

Clinic of Infectious Diseases and Microbiology

20 Citations (Scopus)

Abstract

Background: Corona virus disease 2019 (COVID-19) patients are at increased risk for thromboembolic events. It is unclear whether the risk for gastrointestinal (GI) bleeding is also increased. Methods: We considered 4128 COVID-19 patients enrolled in the Lean European Open Survey on SARS-CoV-2 (LEOSS) registry. The association between occurrence of GI bleeding and comorbidities as well as medication were examined. In addition, 1216 patients from COKA registry were analyzed focusing on endoscopy diagnostic findings. Results: A cumulative number of 97 patients (1.8%) with GI bleeding were identified in the LEOSS registry and COKA registry. Of 4128 patients from the LEOSS registry, 66 patients (1.6%) had a GI bleeding. The rate of GI bleeding in patients with intensive care unit (ICU) admission was 4.5%. The use of therapeutic dose of anticoagulants showed a significant association with the increased incidence of bleeding in the critical phase of disease. The Charlson comorbidity index and the COVID-19 severity index were significantly higher in the group of patients with GI bleeding than in the group of patients without GI bleeding (5.83 (SD = 2.93) vs. 3.66 (SD = 3.06), p < 0.01 and 3.26 (SD = 1.69) vs. 2.33 (SD = 1.53), p < 0.01, respectively). In the COKA registry 31 patients (2.5%) developed a GI bleeding. Of these, the source of bleeding was identified in upper GI tract in 21 patients (67.7%) with ulcer as the most frequent bleeding source (25.8%, n = 8) followed by gastroesophageal reflux (16.1%, n = 5). In three patients (9.7%) GI bleeding source was located in lower GI tract caused mainly by diverticular bleeding (6.5%, n = 2). In seven patients (22.6%) the bleeding localization remained unknown. Conclusion: Consistent with previous research, comorbidities and disease severity correlate with the incidence of GI bleeding. Also, therapeutic anticoagulation seems to be associated with a higher risk of GI bleeding. Overall, the risk of GI bleeding seems not to be increased in COVID-19 patients.

Original language	English
Journal	United European Gastroenterology Journal
Volume	9
Issue number	9
Pages (from-to)	1081-1090
Number of pages	10
ISSN	2050-6406
DOIs	https://doi.org/10.1002/ueg2.12165
Publication status	Published - 11.2021

Funding

The authors express our deep gratitude to all study teams supporting the LEOSS study. The LEOSS study group contributed at least 5 per mille to the analyses of this study: University Hospital Regensburg (Frank Hanses), Hospital Bremen-Center (Christiane Piepel), Technical University of Munich (Christoph Spinner), University Hospital Augsburg (Christoph Roemmele), Hospital St. Joseph-Stift Dresden (Lorenz Walter), University Hospital Tuebingen (Siri Goepel), Johannes Wesling Hospital Minden Ruhr University Bochum (Kai Wille), Hospital Dortmund gGmbH (Martin Hower), University Hospital Jena (Maria Madeleine Ruethrich), University Hospital Schleswig-Holstein Luebeck (Jan Rupp), Municipal Hospital Karlsruhe (Christian Degenhardt), Elisabeth Hospital Essen (Ingo Voigt), Hospital Ingolstadt (Stefan Borgmann), Hospital Passau (Martina Haselberger), Tropical Clinic Paul-Lechler Hospital Tuebingen (Claudia Raichle), University Hospital Duesseldorf (Bjoern-Erik Jensen), University Hospital Frankfurt (Maria Vehreschild), Evangelisches Hospital Saarbruecken (Mark Neufang), Hospitals of Cologne gGmbH (Ana Harth), Hospital Braunschweig (Jan Kielstein), Medical School Hannover (Gernot Beutel), Oberlausitz Hospital (Maximilian Worm), Robert-Bosch-Hospital Stuttgart (Katja Rothfuss), University Hospital Essen (Sebastian Dolff). The LEOSS study infrastructure group: J?rg Janne Vehreschild (Goethe University Frankfurt), Carolin E. M. Jakob (University Hospital of Cologne), Lisa Pilgram (Goethe University Frankfurt), Melanie Stecher (University Hospital of Cologne), Max Schons (University Hospital of Cologne), Susana Nunes de Miranda (University Hospital of Cologne), Clara Bruenn (University Hospital of Cologne), Nick Schulze (University Hospital of Cologne), Sandra Fuhrmann (University Hospital of Cologne), Annika Cla?en (University Hospital of Cologne), Bernd Franke (University Hospital of Cologne), Fabian Pra?er (Charit?, Universit?tsmedizin Berlin) und Martin Lablans (University Medical Center Mannheim). Open access funding enabled and organized by Projekt DEAL.

Research Areas and Centers

Academic Focus: Center for Infection and Inflammation Research (ZIEL)

Coronavirus related work

Research on SARS-CoV-2 / COVID-19

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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@article{13e5003a9c96499590af4fe106c8b25a,

title = "Gastrointestinal bleeding and endoscopic findings in critically and non-critically ill patients with corona virus disease 2019 (COVID-19): Results from Lean European Open Survey on SARS-CoV-2 (LEOSS) and COKA registries",

abstract = "Background: Corona virus disease 2019 (COVID-19) patients are at increased risk for thromboembolic events. It is unclear whether the risk for gastrointestinal (GI) bleeding is also increased. Methods: We considered 4128 COVID-19 patients enrolled in the Lean European Open Survey on SARS-CoV-2 (LEOSS) registry. The association between occurrence of GI bleeding and comorbidities as well as medication were examined. In addition, 1216 patients from COKA registry were analyzed focusing on endoscopy diagnostic findings. Results: A cumulative number of 97 patients (1.8\%) with GI bleeding were identified in the LEOSS registry and COKA registry. Of 4128 patients from the LEOSS registry, 66 patients (1.6\%) had a GI bleeding. The rate of GI bleeding in patients with intensive care unit (ICU) admission was 4.5\%. The use of therapeutic dose of anticoagulants showed a significant association with the increased incidence of bleeding in the critical phase of disease. The Charlson comorbidity index and the COVID-19 severity index were significantly higher in the group of patients with GI bleeding than in the group of patients without GI bleeding (5.83 (SD = 2.93) vs. 3.66 (SD = 3.06), p < 0.01 and 3.26 (SD = 1.69) vs. 2.33 (SD = 1.53), p < 0.01, respectively). In the COKA registry 31 patients (2.5\%) developed a GI bleeding. Of these, the source of bleeding was identified in upper GI tract in 21 patients (67.7\%) with ulcer as the most frequent bleeding source (25.8\%, n = 8) followed by gastroesophageal reflux (16.1\%, n = 5). In three patients (9.7\%) GI bleeding source was located in lower GI tract caused mainly by diverticular bleeding (6.5\%, n = 2). In seven patients (22.6\%) the bleeding localization remained unknown. Conclusion: Consistent with previous research, comorbidities and disease severity correlate with the incidence of GI bleeding. Also, therapeutic anticoagulation seems to be associated with a higher risk of GI bleeding. Overall, the risk of GI bleeding seems not to be increased in COVID-19 patients.",

author = "\{the LEOSS Study Group\} and Stephan Zellmer and Frank Hanses and Anna Muzalyova and Johanna Classen and Georg Braun and Christiane Piepel and Johanna Erber and Lisa Pilgram and Lorenz Walter and Siri G{\"o}pel and Kai Wille and Martin Hower and R{\"u}thrich, \{Maria Madeleine\} and Jan Rupp and Christian Degenhardt and Ingo Voigt and Stefan Borgmann and Melanie Stecher and Carolin Jakob and Christine Dhillon and Helmut Messmann and Alanna Ebigbo and Christoph R{\"o}mmele",

note = "Publisher Copyright: {\textcopyright} 2021 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology.",

year = "2021",

month = nov,

doi = "10.1002/ueg2.12165",

language = "English",

volume = "9",

pages = "1081--1090",

journal = "United European Gastroenterology Journal",

issn = "2050-6406",

publisher = "John Wiley \& Sons Inc.",

number = "9",

}

Gastrointestinal bleeding and endoscopic findings in critically and non-critically ill patients with corona virus disease 2019 (COVID-19): Results from Lean European Open Survey on SARS-CoV-2 (LEOSS) and COKA registries. / the LEOSS Study Group.
In: United European Gastroenterology Journal, Vol. 9, No. 9, 11.2021, p. 1081-1090.

Research output: Journal Articles › Journal articles › Research › peer-review

TY - JOUR

T1 - Gastrointestinal bleeding and endoscopic findings in critically and non-critically ill patients with corona virus disease 2019 (COVID-19)

T2 - Results from Lean European Open Survey on SARS-CoV-2 (LEOSS) and COKA registries

AU - the LEOSS Study Group

AU - Zellmer, Stephan

AU - Hanses, Frank

AU - Muzalyova, Anna

AU - Classen, Johanna

AU - Braun, Georg

AU - Piepel, Christiane

AU - Erber, Johanna

AU - Pilgram, Lisa

AU - Walter, Lorenz

AU - Göpel, Siri

AU - Wille, Kai

AU - Hower, Martin

AU - Rüthrich, Maria Madeleine

AU - Rupp, Jan

AU - Degenhardt, Christian

AU - Voigt, Ingo

AU - Borgmann, Stefan

AU - Stecher, Melanie

AU - Jakob, Carolin

AU - Dhillon, Christine

AU - Messmann, Helmut

AU - Ebigbo, Alanna

AU - Römmele, Christoph

PY - 2021/11

Y1 - 2021/11

N2 - Background: Corona virus disease 2019 (COVID-19) patients are at increased risk for thromboembolic events. It is unclear whether the risk for gastrointestinal (GI) bleeding is also increased. Methods: We considered 4128 COVID-19 patients enrolled in the Lean European Open Survey on SARS-CoV-2 (LEOSS) registry. The association between occurrence of GI bleeding and comorbidities as well as medication were examined. In addition, 1216 patients from COKA registry were analyzed focusing on endoscopy diagnostic findings. Results: A cumulative number of 97 patients (1.8%) with GI bleeding were identified in the LEOSS registry and COKA registry. Of 4128 patients from the LEOSS registry, 66 patients (1.6%) had a GI bleeding. The rate of GI bleeding in patients with intensive care unit (ICU) admission was 4.5%. The use of therapeutic dose of anticoagulants showed a significant association with the increased incidence of bleeding in the critical phase of disease. The Charlson comorbidity index and the COVID-19 severity index were significantly higher in the group of patients with GI bleeding than in the group of patients without GI bleeding (5.83 (SD = 2.93) vs. 3.66 (SD = 3.06), p < 0.01 and 3.26 (SD = 1.69) vs. 2.33 (SD = 1.53), p < 0.01, respectively). In the COKA registry 31 patients (2.5%) developed a GI bleeding. Of these, the source of bleeding was identified in upper GI tract in 21 patients (67.7%) with ulcer as the most frequent bleeding source (25.8%, n = 8) followed by gastroesophageal reflux (16.1%, n = 5). In three patients (9.7%) GI bleeding source was located in lower GI tract caused mainly by diverticular bleeding (6.5%, n = 2). In seven patients (22.6%) the bleeding localization remained unknown. Conclusion: Consistent with previous research, comorbidities and disease severity correlate with the incidence of GI bleeding. Also, therapeutic anticoagulation seems to be associated with a higher risk of GI bleeding. Overall, the risk of GI bleeding seems not to be increased in COVID-19 patients.

AB - Background: Corona virus disease 2019 (COVID-19) patients are at increased risk for thromboembolic events. It is unclear whether the risk for gastrointestinal (GI) bleeding is also increased. Methods: We considered 4128 COVID-19 patients enrolled in the Lean European Open Survey on SARS-CoV-2 (LEOSS) registry. The association between occurrence of GI bleeding and comorbidities as well as medication were examined. In addition, 1216 patients from COKA registry were analyzed focusing on endoscopy diagnostic findings. Results: A cumulative number of 97 patients (1.8%) with GI bleeding were identified in the LEOSS registry and COKA registry. Of 4128 patients from the LEOSS registry, 66 patients (1.6%) had a GI bleeding. The rate of GI bleeding in patients with intensive care unit (ICU) admission was 4.5%. The use of therapeutic dose of anticoagulants showed a significant association with the increased incidence of bleeding in the critical phase of disease. The Charlson comorbidity index and the COVID-19 severity index were significantly higher in the group of patients with GI bleeding than in the group of patients without GI bleeding (5.83 (SD = 2.93) vs. 3.66 (SD = 3.06), p < 0.01 and 3.26 (SD = 1.69) vs. 2.33 (SD = 1.53), p < 0.01, respectively). In the COKA registry 31 patients (2.5%) developed a GI bleeding. Of these, the source of bleeding was identified in upper GI tract in 21 patients (67.7%) with ulcer as the most frequent bleeding source (25.8%, n = 8) followed by gastroesophageal reflux (16.1%, n = 5). In three patients (9.7%) GI bleeding source was located in lower GI tract caused mainly by diverticular bleeding (6.5%, n = 2). In seven patients (22.6%) the bleeding localization remained unknown. Conclusion: Consistent with previous research, comorbidities and disease severity correlate with the incidence of GI bleeding. Also, therapeutic anticoagulation seems to be associated with a higher risk of GI bleeding. Overall, the risk of GI bleeding seems not to be increased in COVID-19 patients.

UR - https://www.scopus.com/pages/publications/85117104802

U2 - 10.1002/ueg2.12165

DO - 10.1002/ueg2.12165

M3 - Journal articles

C2 - 34655180

AN - SCOPUS:85117104802

SN - 2050-6406

VL - 9

SP - 1081

EP - 1090

JO - United European Gastroenterology Journal

JF - United European Gastroenterology Journal

IS - 9

ER -

Gastrointestinal bleeding and endoscopic findings in critically and non-critically ill patients with corona virus disease 2019 (COVID-19): Results from Lean European Open Survey on SARS-CoV-2 (LEOSS) and COKA registries

Abstract

Funding

Research Areas and Centers

Coronavirus related work

UN SDGs

Access to Document

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Cite this