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



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Table 1. All GI bleeding characteristics (N=314)

Characteristic

GI bleed timing, n (%)

     On admission

     During inpatient

104 (33.12)

210 (66.88)

ICU stay among GI bleeders during 

inpatient, n (%)

     Yes

     No


96 (45.71)

114 (54.29)

Bleed location, n (%)

     Upper

     Lower

214 (68.15)

100 (31.85)

PRBC, n (%)

     Yes

     No


144 (45.86)

170 (54.14)

PRBC units (n=144)

     Mean (SD)

     Median (IQR)

3.05 (3.03)

2.00 (1.00, 3.00)

Endoscopy, n (%)

     Yes

     No


20 (6.37)

294 (93.63)

Endoscopy type (n=20), n (%)

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     EGD


     Colonoscopy

     Sigmoidoscopy

17 (85.00)

2 (10.00)

1 (5.00)

Endoscopy findings (n=20), n (%)

     Gastroduodenal ulcer

     NML


     Gastritis

     Esophagitis

     Diverticular bleeding

     Colitis

     Vascular ectasias

11 (55.00)

3 (15.00)

2 (10.00)

1 (5.00)

1 (5.00)


1 (5.00)

1 (5.00)


GBB score (n=176)

     Mean (SD)

     Median (IQR)

8.85 (4.48)

10.00 (6.00, 12.50)

Minimum HGB value (g/dL)

     Mean (SD)

     Median (IQR)

8.44 (2.41)

7.80 (6.80, 10.00)

Length of stay

     On admission bleeders (n=104)

          Mean (SD)

          Median (IQR)

     During inpatient bleeders (n=210)

8.41 (6.25)

7.00 (4.00, 10.00)

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          Mean (SD)

          Median (IQR)

15.41 (12.26)

11.50 (6.00, 22.00)

GI, gastrointestinal; ICU, intensive care unit; PRBC, packed red blood cells; EGD, esophagogastroduodenoscopy; GBS, 

Glasgow-Blatchford bleeding Score; HGB, hemoglobin; SD, standard deviation; IQR, interquartile range.

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Table 2. Demographic characteristics and comorbidities of individuals after matching gastrointestinal bleed on admission and 

during hospitalization 

Characteristic

GI bleed on 

admission

(n=104)

No GI bleed on 

admission

(n=104)


Absolute 

standardized 

difference*

GI bleed 

during 

hospitalization

(n=210)

No GI bleed 

during 

hospitalization

(n=210)

Absolute 

standardized 

difference*

Age

     Mean (SD)



     Median (IQR)

70.24 (14.40)

72.00 (61.50, 

80.50)


71.25 (15.61)

75.00 (62.00, 

83.50)

0.06425


69.43 (14.31)

70.00 (62.00, 

80.00)

71.58 (14.25)



73.00 (63.00, 

82.00)


0.13703

Sex, n (%)

     Male

     Female

54 (51.92)

50 (48.08)

51 (49.04)

53 (50.96)

0.05808

133 (63.33)

77 (36.67)

137 (65.24)

73 (34.76)

0.03904


Race, n (%)

     White

     Black/ African 

American


     Asian

     Other/ Multiracial

49 (47.12)

24 (23.08)

10 (9.62)

16 (15.38)

5 (4.81)

53 (50.96)

23 (22.12)

9 (8.65)


17 (16.35)

2 (1.92)


0.07796

0.02318


0.03347

0.02367


0.13438

89 (42.38)

40 (19.05)

21 (10.00)

48 (22.86)

12 (5.71)

96 (45.71)

40 (19.05)

18 (8.57)

48 (22.86)

8 (3.81)

0.06800


0.00000

0.04927


0.00000

0.08507


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     Unknown/ Declined

Ethnicity

     Non-Hispanic/ Latino

     Hispanic/ Latino

     Unknown/ Declined   

88 (84.62)

9 (8.65)


7 (6.73)

91 (87.50)

8 (7.69)

5 (4.81)


0.07065

0.02727


0.07753

156 (74.29)

39 (18.57)

15 (7.14)

157 (74.76)

40 (19.05)

13 (6.19)

0.01073


0.01189

0.03785


Charlson Comorbidity 

Index


     Mean (SD)

     Median (IQR)

6.26 (3.23)

6.00 (4.00, 8.00)

6.21 (3.53)

6.00 (3.50, 8.00)

0.01430

6.67 (3.91)

6.00 (4.00, 

9.00)


6.87 (3.79)

6.50 (4.00, 

9.00)

0.05528


ESRD

     Yes


     No

7 (6.73)


97 (93.27)

3 (2.88)


101 (97.12)

0.17100


21 (10.00)

189 (90.00)

16 (7.62)

194 (92.38)

0.09397

PUD


     Yes

     No


1 (0.96)

103 (99.04)

0 (0.00)

104 (100.00)

0.10691

8 (3.81)


202 (96.19)

10 (4.76)

200 (95.24)

0.06473


Diverticulosis

     Yes


     No

3 (2.88)


101 (97.12)

4 (3.85)


100 (96.15)

0.06892


7 (3.33)

203 (96.67)

8 (3.81)

202 (96.19)

0.03242

IBD/ Ulcerative colitis/ 

Chron’s disease

     Yes


     No

1 (0.96)


103 (99.04)

0 (0.00)


104 (100.00)

0.11969


1 (0.48)

209 (99.52)

2 (0.95)

208 (99.05)

0.07471

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Prior GI bleed

     Yes

     No


1 (0.96)

103 (99.04)

0 (0.00)

104 (100.00)

0.10661

8 (3.81)


202 (96.19)

10 (4.76)

200 (95.24)

0.06460


*An absolute standardized difference of <0.25 is considered acceptable covariate balance for acceptable matching.

SD, standard deviation; IQR, interquartile range; GI, gastrointestinal; ESRD, end stage renal disease; IBD, inflammatory bowel 

disease.

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Table 3. Medication risk factors for gastrointestinal bleed during hospitalization

Medication

GI bleed


(n=210)

No GI bleed

(n=210)

Multivariable OR 

(95% CI)

p-value


Antiplatelet (hospital)

     Yes


     No

92 (43.81)

118 (56.19)

88 (41.90)

122 (58.10)

1.12 (0.65, 1.95)

0.6774

Anticoagulant (hospital)



     Yes

     No


130 (61.90)

80 (38.10)

123 (58.57)

87 (41.43)

1.14 (0.77, 1.70)

0.5109


PPI (hospital)

     Yes


     No

79 (37.62)

131 (62.38)

68 (32.38)

142 (67.62)

1.58 (0.98, 2.54)

0.0614

Steroid (hospital)



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     Yes


     No

114 (54.29)

96 (45.71)

107 (50.95)

103 (49.05)

1.10 (0.74, 1.64)

0.6384

H2R blocker (hospital)



     Yes

     No


32 (15.24)

178 (84.76)

26 (12.38)

184 (87.62)

1.25 (0.70, 2.25)

0.4456


NSAID  (hospital)

     Yes


     No

8 (3.81)


202 (96.19)

16 (7.62)

194 (92.38)

0.50 (0.21, 1.17)

0.1083

*Multivariable ORs are specific to medication type.



GI, gastrointestinal; PPI, proton pump inhibitor; H2R, Histamine 2 receptor blocker; NSAID, non-steroidal anti-inflammatory 

drugs.


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