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    Outcome of Conservative Therapy in COVID-19 MESHD Patients Presenting with Gastrointestinal Bleeding

    Authors: Shalimar; Manas Vaishnav; Anshuman Elhence; Ramesh Kumar; Srikant Mohta; Chandan Palle; Peeyush Kumar; Mukesh Ranjan; Tanmay Vajpai; Shubham Prasad; Jatin Yegurla; Anugrah Dhooria; Vikas Banyal; Samagra Agarwal; Rajat Bansal; Sulagna Bhattacharjee; Richa Aggarwal; Kapil D Soni; Swetha Rudravaram; Ashutosh K Singh; Irfan Altaf; Avinash Choudekar; Soumya J Mahapatra; Deepak Gunjan; Saurabh Kedia; Govind Makharia; Anjan Trikha; Pramod Garg; Anoop Saraya

    doi:10.1101/2020.08.06.20169813 Date: 2020-08-07 Source: medRxiv

    Background: There is a paucity of data on the management of gastrointestinal(GI) bleeding MESHD in patients with COVID-19 MESHD amid concerns about the risk of transmission during endoscopic procedures.We aimed to study the outcomes of conservative treatment for GI bleeding MESHD in patients with COVID-19 MESHD. Methods: In this retrospective analysis, 24 of 1342(1.8%) patients with COVID-19 MESHD, presenting with GI bleeding MESHD from 22ndApril to 22ndJuly 2020, were included. Results: The mean age of patients was 45.8+/-12.7 years; 17(70.8%) were males; upper GI(UGI) bleeding MESHD: lower GI MESHD(LGI) 23:1. Twenty-two(91.6%) patients had evidence of cirrhosis MESHD- 21 presented with UGI bleeding MESHD while one had bleeding MESHD from hemorrhoids MESHD. Two patients without cirrhosis MESHD were presumed to have non-variceal bleeding MESHD. The medical therapy for UGI bleeding included vasoconstrictors- somatostatin in 17(73.9%) and terlipressin in 4(17.4%) patients. All patients with UGI bleeding MESHD received proton pump inhibitors and antibiotics. Packed red blood cells(PRBCs), fresh frozen plasma and platelets were transfused in 14(60.9%), 3(13.0%) and 3(13.0%), respectively. The median PRBCs transfused was 1(0-3) unit(s). The initial control of UGI bleeding MESHD was achieved in all 23 patients and none required an emergency endoscopy. At 5-day follow-up, none rebled or died. Two patients later rebled, one had intermittent bleed due to gastric antral vascular ectasia MESHD, while another had rebleed 19 days after discharge. Three(12.5%) cirrhosis MESHD patients succumbed to acute hypoxemic respiratory failure MESHD during hospital stay. Conclusion: Conservative management strategies including pharmacotherapy, restrictive transfusion strategy, and close hemodynamic monitoring can successfully manage GI bleeding MESHD in COVID-19 MESHD patients and reduce need for urgent endoscopy.

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MeSH Disease
HGNC Genes
SARS-CoV-2 Proteins


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