P0599 - COVID-19 in Non-Variceal Upper GI Bleeding: A National Cohort Study

Aizaz Khan, MD¹, Kamesh Gupta, MD², Victoria Caruso, DO^2
1University of Massachusetts Chan Medical School-Baystate, Springfield, MA; ²University of Massachusetts-Chan Baystate Medical Center, Springfield, MA

Introduction: Coronavirus disease 2019 (COVID-19) was one of the most devastating pandemic in the modern world. Simultaneous upper gastrointestinal bleeding (UGIB) in patients with COVID-19 infection has been reported to have mortality as high as 41.9%. We present the largest dataset to date on non variceal upper gastrointestinal bleeding (NVUGIB) in patients with COVID-19 in the United States, evaluating incidence and outcomes.

Methods: We conducted a retrospective analysis reviewing the National Inpatient Sample database for hospitalizations that included ICD-10 codes for Upper GI non-variceal bleeding during 2020. These were further subdivided based upon if they had COVID-19. Baseline characteristics were compared using t-test and chi-square tests. Hospitalization outcomes were analyzed using a multivariate logistic regression model to control for age, race, Charlson comorbidity index, intensive care unit (ICU) admission, shock and acute renal failure.

Results: Of 336,088 hospitalizations with NVUGIB in 2020, 5809 (1.75%) patients had concurrent COVID-19. These COVID-19 patients were more likely to be black (19.3% vs 15%, p< 0.01) or hispanic (17.9% vs 9.6%, p< 0.01), were of slightly older age (65.9 vs 65.5, p=0.003), less likely to be females (44.5% vs 46.4%, p< 0.01), and were less likely to have ≥ 3 comorbidities (53.8% vs 55.3%, p< 0.01). COVID-19 group had a higher mortality rate (6.8% vs 2.4%, odds ratio (OR) 2.97, 95% confidence interval (CI): 2.35-3.76), length of stay (5.49 vs 7.81 days, OR 2.31, 1.82-2.8), and total charges for the hospitalization ($90469 vs $75830, OR 14638, OR 6836-22439). Mean time from presentation to undergoing esophagogastroduodenoscopy (EGD) was marginally higher for COVID-19 infected individuals (2.0±.02 days vs 1.9±0.01 days, p< 0.001). NVUGIB patients with COVID-19 patients were less likely to undergo EGD during the hospitalization (42.3% vs 60.2%, p< 0.001) and less likely to have EGD performed within 24 hours of presentation (20.7% vs 32.8%, OR 0.53, 0.46-0.61).

Discussion: Our nationally representative data suggests concurrent NVUGIB in patients with COVID-19 infection significantly increased mortality rates and healthcare utilization. The mortality rate in our study is lesser than the previously reported single center studies. Endoscopy was performed less frequently in COVID-19 patients with NVUGIB, along with a significant delay in time-to-EGD, although we could not provide evidence whether endoscopy was beneficial for these patients.


Disclosures:


Aizaz Khan, MD¹, Kamesh Gupta, MD², Victoria Caruso, DO². P0599 - COVID-19 in Non-Variceal Upper GI Bleeding: A National Cohort Study, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.