Gastrointestinal Bleeding in Hospitalized covid‐19 Patients: a propensity Score Matched Cohort Study

Accepted Article

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COVID-19 patients with GI bleeding were matched 1:1 to COVID-19 patients without bleeding using 

a propensity score that took into account comorbidities, demographics, GI bleeding risk factors, and 

length of stay.

Results: Of 11, 158 hospitalized with COVID-19, 314 patients were identified with GI bleeding. The 

point prevalence of GI bleeding was 3%. There were no identifiable risk factors for GI bleeding.  Use 

of anticoagulation medication or antiplatelet agents were not associated with increased risk of GI 

bleeding in COVID-19 patients. For patients that developed a GI bleed during the hospitalization, 

there was an increased mortality risk in the GI bleeding group (OR 1.58, p=0.02).

Conclusion: Use of anticoagulation or antiplatelet agents were not risk factors for GI bleeding in a 

large cohort of hospitalized COVID-19 patients. Those with GI bleeding during the hospitalization 

had increased mortality. 

KEYWORDS: SARS-CoV-2; endoscopy; melena; hematochezia; anticoagulation

INTRODUCTION

The novel coronavirus disease (COVID-19) has evolved into a global pandemic.  Millions have been 

infected in the United States with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) 

virus of whom over 200,000 people have died to date[1].  Though most widely known for its 

pulmonary manifestation, it has become evident that COVID-19 results in systemic complications, 

including the gastrointestinal system [2,3]. Importantly, observational studies have shown that