Gastrointestinal Bleeding in Hospitalized COVID-19 Patients: A Propensity Score Matched Cohort Study.

Background and aims Gastrointestinal (GI) bleeding has been observed among patients hospitalized with COVID-19. Recently anticoagulation has shown to decrease mortality, but it is unclear if this contributes to increased GI bleeding. The aims of this study are: 1) to examine if there are risk factors for GI bleeding in COVID-19 patients 2) to study whether there is a mortality difference between hospitalized patients with COVID-19 with and without GI bleeding. Methods This is a propensity score matched case-control study from a large health system in the New York metropolitan area between March 1st and April 27th . 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.