Gastrointestinal Bleeding: Prevalence, Etiology, and Outcomes in COVID-19 Inpatients

Sara Shafieipour, Esmaeil Mohammadi, Mohammad Rezaei Zadeh Rukerd, Reza Momenai, Mohammad Mehdi Lashkarizadeh, Mohammad Javad Zahedi, Mohammad Mahdi Hayatbakhsh Abbasi, Sodeif Darvish-Moghadam, Seyed Mehdi Seyed Mirzaei, Bijan Ahmadi, Ali Saeidpour, Omid Eslami, Ali Akbar Khalesi, Sadegh Miraki, Mohsen Nakhaie



The current study aimed to investigate the prevalence, risk factors, endoscopic findings, and outcome of gastrointestinal bleeding in COVID-19 hospitalized patients.

Materialsand Methods:

This study is a retrospective review of COVID-19 hospitalized patients with gastrointestinal bleeding from a large university hospital in southeast Iran. This study was conducted over one year from April 2020 to March 2021.


 Out of 3563 COVID-19 inpatients with approximately equal sex distribution (52.5% of men and 47.5% of women), 80 (2.24%) patients with a mean age of 58.01 ± 20.71 were identified with signs of gastrointestinal bleeding, including; melena (48.8%), hemoglobin drop (42.5%), fresh blood hematemesis (31.3%), rectorrhagia (20%) and coffee ground emesis (10%). 52 patients (65%) had signs of gastrointestinal bleeding on admission, and 28 patients (35%) developed gastrointestinal bleeding during their hospital admissions, most of whom were men (63.8%). Endoscopic characteristics were; gastric erosion (27.7%), gastric ulcer (23%), duodenal ulcer (21.5%), esophageal ulcer (12.3%), and esophageal erosion (6.1%) in upper gastrointestinal endoscopy. On colonoscopy, hemorrhoids (25%), mass lesions (16%), fissures (8.3%), diverticular lesions (8.3%), and polyps (8.3%) were the most common findings. The overall mortality of the patients in the present study was 36.2%. However, gastrointestinal bleeding-related deaths were 7.5%.


Gastrointestinal bleeding was identified in 2.24% of hospitalized COVID-19 patients, with gastroduodenal ulcers and erosions as the most common symptoms.


COVID-19, Gastrointestinal Tract, Hemorrhage, Endoscopy, Colonoscopy, Iran

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