Results of endoscopic hemostasis methods in treatment of gastrointestinal bleeding in patients with SARS-CoV-2

Abstract

The development of gastrointestinal bleeding from erosive and ulcerative defects of the mucous membranes of the upper gastrointestinal tract, which, according to the world literature, occurs in 2–13 % of hospitalized patients with COVID-19, is a multifaceted problem that is still relevant, but has not been adequately reflected in scientific publications. The aim of the work was to study the clinical characteristics of patients with gastrointestinal bleeding on the background of SARS-CoV-2 and evaluate the methods of endoscopic hemostasis. The article analyzed cases of bleeding from the upper gastrointestinal tract in 115 patients suffering from the novel coronavirus infection. The severity of the course of COVID-19 was assessed according to the criteria of the NEWS scale, the degree of respiratory failure, and radiological data. 114 out of 115 patients had comorbidities; the most common diseases were cardiovascular diseases, endocrine pathology, chronic kidney disease, and oncopathology. The most common sources of bleeding (82 %) were acute or chronic ulcers of the stomach and/or duodenum against the background of erosive hemorrhagic lesions of the mucosa. The following methods of endoscopic hemostasis were used: endoscopic clipping, endoscopic injections, applications of hemostatic agents and solutions, and combined methods which were used more often. Hemostasis was achieved in all cases. Repeated bleeding occurred in 22 cases (19.1 %) with subsequent achievement of endo-hemostasis. Mortality was 66.95 % (77 patients), with such causes of adverse outcomes as increasing multiple organ failure, respiratory distress syndrome, and septic shock.