Outcomes of Upper Gastrointestinal Bleeding in Hospitalized COVID-19 Patients in the United States: A Propensity-score Matched Analysis of a Large National Database

Authors

Moon Ryu
Mohammed Quazi
Niloy Ghosh
Karthik Gangu
Amir H Sohail
Asif Farooq
Babu S Maringanti
Aman Goyal
Anupa Patel
Muhammad S Khan
Abu B Sheikh

Publication Date

1-1-2024

Journal

Journal of Community Hospital Internal Medicine Perspectives

Abstract

Patients with cirrhosis that are hospitalized with COVID-19 infection have been found to have worse outcomes. No comparative study has been conducted between gastrointestinal (GI) bleeding in patients with cirrhosis who are diagnosed with COVID-19. We utilized the National Inpatient Sample (NIS) database to perform a retrospective analysis of 24, 050 patients diagnosed with cirrhosis and COVID-19. The identified patients were separated into variceal bleeding, nonvariceal bleeding, and no (or neither) GI bleeding groups. After performing propensity sample matching and multivariate analysis of mortality, we found no significant differences in mortality among the three groups. However, the variceal bleed group had a shorter length of stay (5.67 days lower than the no-bleed group). Esophagogastroduodenoscopy (EGD) with intervention was associated with reduced mortality in the variceal and nonvariceal bleeding groups. Acute kidney injury was a strong predictor of mortality in both bleeding groups. A native American race was found to be associated with higher mortality in the nonvariceal bleeding group. Our study suggests that there are various pathophysiological processes among the three groups, with no significant mortality differences with cirrhosis complications of GI bleeding.

Keywords

Coronavirus disease, Liver cirrhosis, Esophageal varices, Gastrointestinal bleeding, Gastrointestinal complications, Acute kidney injury

Comments

PMID: 38966514