Upper gastrointestinal endoscopy in patients hospitalized with COVID-19: experience in an university hospital
DOI:
https://doi.org/10.22421/1517-7130/es.2025v26.e1048Keywords:
Endoscopy, COVID-19, Patient SafetyAbstract
Although COVID-19 primarily affects the respiratory system, the virus can also directly invade other organs, including the gastrointestinal (GI) tract. This retrospective, cross-sectional, observational, single-center study aimed to assess the indications, findings, and therapeutic interventions of upper GI endoscopy in patients with COVID-19 hospitalized at a university hospital during the pandemic. Additionally, the study explored the potential association between GI involvement and increased mortality, as evaluated by the Rockall score. The analysis revealed that only a minority of patients exhibited
significant endoscopic findings or required therapeutic intervention. These results underscore the importance of optimizing endoscopy referral practices to minimize unnecessary procedures that may pose more risks than benefits. Nevertheless,
the presence of GI manifestations appeared to correlate with moderate to high Rockall scores and poorer prognoses. Therefore, the management of GI symptoms in COVID-19 patients is complex and necessitates careful consideration of both patient outcomes and healthcare worker safety.
References
Aguila EJT, Cua IHY, Dumagpi JEL, Francisco CPD, Raymundo NTV, Sy‐Janairo MLL et al. COVID‐19 and its effects on the digestive system and endoscopy practice. JGH Open. [Internet] 2020 [citado 30 de jan 2024]; 4(3):324–31. Disponível em: https://pubmed.ncbi.nlm.nih.gov/32514432/
Alves MR, Souza-Santos R, Almeida AS. Space-time clusters of severe acute respiratory syndrome and COVID-19 and hierarchical urban network in the state of Mato Grosso, Brazil, 2020-2021. Espac. Saude [Internet]. 2022 [citado 12 de out 2024];23. Disponível em: https://espacoparasaude.fpp.edu.br/index.php/espacosaude/article/view/836
Benites-Goñi H, Martín Pascacio-Fiori, Fiorella Monge-Del Valle, Zuly Plácido-Damián, Gonzales-Carazas E, Padilla-Espinoza M et al. Impact of the COVID-19 pandemic in the time to endoscopy in patients with upper gastrointestinal bleeding. Rev Gastroenterol Perú [Internet]. 2020 [citado 12 de out 2024];40(3):219–9. Disponível em: https://revistagastroperu.com/index.php/rgp/article/view/1120
Calderón CLG, Huerta MM. Hemorragia digestiva alta y mortalidad en pacientes hospitalizados con COVID-19: revisión sistemática y metaanálisis. Lima: Faculdade de Medicina da Universidad Peruana Cayetano Heredia [Trabalho de Conclusão de Residência] [Internet] 2021 [citado 12 de out 2024]; Disponível em: https://repositorio.upch.edu.pe/handle/20.500.12866/9721
Cappell BMS, Friedel DM. Gastrointestinal bleeding in COVID-19-infected patients. Gastroenterology Clinics of North America [Internet]. 2022 [citado 30 de jan 2024]; 52(1):77-102. Disponível em: 10.1016/j.gtc.2022.10.004
Cazacu SM, Burtea DE, Iovănescu VF, Florescu DN, Iordache S, Turcu-Stiolica A et al. Outcomes in patients admitted for upper gastrointestinal bleeding and COVID-19 infection: a study of two years of the pandemic. Life. [Internet] 2023 [citado 30 de jan 2024]; 13(4):890. Disponível em: https://pubmed.ncbi.nlm.nih.gov/37109419/
Costa ACFGS, Fonseca Neto OCL.. Sangramento gastrointestinal em pacientes com COVID-19: uma revisão integrativa. Rev Col Bras Cir [Internet]. 2024 [citado 12 de out 2024]; 51:e20243600. Disponível em: https://www.scielo.br/j/rcbc/a/tcPCbg5LdZWVDxM9WLNQ8cd/?lang=pt
Elshazli RM, Kline A, Elgaml A, Aboutaleb MH, Salim MM, Omar M et al. Gastroenterology manifestations and COVID‐19 outcomes: A meta‐analysis of 25,252 cohorts among the first and second waves. J Med Virol [Internet]. 2021 [citado 12 de out 2024]; 93(5):2740–68. Disponível em: https://pmc.ncbi.nlm.nih.gov/articles/PMC8014082/
Karlafti E, Tsavdaris D, Kotzakioulafi E, Protopapas AA, Kaiafa G, Netta S et al. The Prevalence of Gastrointestinal Bleeding in COVID-19 Patients: A Systematic Review and Meta-Analysis. Medicina (Kaunas) [Internet]. 2023 [citado 17 de jun 2024];59(8):1500. Disponível em: https://pubmed.ncbi.nlm.nih.gov/37629790/
Kuftinec G, Elmunzer BJ, Amin S. The role of endoscopy and findings in COVID-19 patients, an early North American Cohort. BMC Gastroenterology. [Internet]. 2021 [citado 30 de jan 2024]; 21(1):205. Disponível em: https://pubmed.ncbi.nlm.nih.gov/33962582/
Mauro A, De Grazia F, Lenti MV, Penagini R, Frego R, Ardizzone S et al. Upper gastrointestinal bleeding in COVID-19 inpatients: Incidence and management in a multicenter experience from Northern Italy. Clinics and Research in Hepatology and Gastroenterology [Internet]. 2021 [citado 30 de jan 2024]; 45(3):101521.Disponível em: https://www.sciencedirect.com/science/article/pii/S2210740120302163
Rosevics L, Fossati BS, Teixeira S, Bem RS, Souza RCA. COVID-19 and digestive endoscopy: emergency endoscopic procedures and risk factors for upper gastrointestinal bleeding. Arquiv Gastroenterol [Internet]. 2021 [citado 21 de fev 2025];58(3):337–43. Disponível em: https://www.scielo.br/j/ag/a/sNZbvtrFgMQpVzDsWQ5Dxdv/
Silaghi A, Gaspar BS, Epistatu D, Bălan DG, Păunică I, Dumitriu AS et al. Upper gastrointestinal bleeding during the COVID-19 pandemic; particularities of diagnosis and therapy. J Mind Med Sci [Internet]. 2022 [citado 12 de out 2024]; 9(2). Disponível em: https://scholar.valpo.edu/jmms/vol9/iss2/10/
Sinonquel P, Roelandt P, Demedts I, Van Gerven L, Vandenbriele C, Wilmer A et al. COVID-19 and gastrointestinal endoscopy: What should be taken into account? Dig Endosc. [Internet]. 2020 [citado 21 de fev 2025]; 32(5):723-31. Disponível em: https://pubmed.ncbi.nlm.nih.gov/32335962/
Sociedade Brasileira de Endoscopia Digestiva. Recomendações SOBED para endoscopia segura durante a pandemia por coronavírus: documento 004/2020-20/04/2020. [citado 12 de out 2024]. São Paulo: SOBED; 2020. Disponível em: https://www.sobed.org.br/fileadmin/user_upload/sobed/2020/04/21/ENDOSCOPIA_SEGURA_SOBED__004_20_04_2020_final.pdf
Tarik A, Soukaina R, Samir M, Asmae S, Ahlame B, Rida B et al. Gastrointestinal manifestations with COVID-19 virus infection: A Moroccan prospective study. Arab Journal of Gastroenterology [Internet]. 2021 [citado 12 de out 2024]; 22(4):305–9. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8321706/
Torres AP. Endoscopia digestiva en tiempos de covid-19: Resumen de recomendaciones. Rev Colomb Cir. [Internet] 2020 [citado 21 de fev 2025]; 35(2):209–15. Disponível em: https://www.revistacirugia.org/index.php/cirugia/article/view/622
World Health Organization. Number of COVID-19 deaths reported to WHO. WHO COVID-19 Dashboard [Internet]. 2024. [citado 12 de out 2024]. Disponível em: https://data.who.int/dashboards/covid19/deaths?n=o
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Copyright (c) 2025 Jessica Rodrigues Pires da Silva, Ricardo Jacarandá de Faria, Júlia Maroccolo da Silva Lima, Vinícius Machado de Lima, Fabiane Braga Leonor, Fabio Santana Bolinja Rodrigues
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