P2030 - SARS-CoV-2 Gastrointestinal Symptoms and One-Year Risk for Gastrointestinal Bleed: A Retrospective Cohort Study

Vincent J. Maffei, MD, PhD, Robert Dorrell, MD, Elizabeth T.. Jensen, MPH, PhD, Steven Clayton, MD
Wake Forest University School of Medicine, Winston-Salem, NC

Introduction: Gastrointestinal symptoms are common in SARS-CoV-2 infection. SARS-CoV-2 infects enterocytes and sheds in feces up to seven months despite respiratory clearance. Persistent viral inflammation may contribute to risk of future GI complications including GI bleed. The study objective was to identify risk factors associated with GI bleeding within one year after COVID-19 diagnosis. We hypothesized that GI symptoms at presentation would be positively associated with risk for a GI bleed event.

Methods: We conducted a retrospective cohort study using electronic health record data from a tertiary health care system representing five emergency departments (EDs). Using ICD-10-CM codes, we identified adult patients with a first-ever COVID-19 diagnosis between January 1, 2020 and September 29, 2021 in the ED and assessed the frequency of a subsequent GI bleed event within 12 months. Patients who expired before 12 months were excluded. Using logistic regression, we calculated the adjusted odds of a GI bleed in relation to COVID-19 symptoms at ED presentation.

Results: We identified n=1,510 cases of COVID-19 that met the study criteria including complete review of systems responses prior to discharge from the ED or the inpatient service. On presentation, the prevalence of any GI symptom (abdominal pain, diarrhea, vomiting, or nausea) was 44% while the prevalence of any respiratory symptom (dyspnea or cough) was 74%. Twenty-six (1.7%) patients presented with a new GI bleed within 12 months from their index COVID-19 diagnosis with a median time to event of 102 days (IQR: 194). Melena (n=10), hematochezia (n=8), hematemesis (n=6), positive fecal occult (n=1), and unexplained anemia (n=1) were the GI bleed presenting complaints. Abdominal pain at the time of COVID-19 diagnosis was reported in 6 of 26 (23%) GI bleed cases compared to 117 of 1,484 (7.9%) without a GI bleed and was significantly associated with the GI bleed event (adjusted OR: 3.40; 95% CI: 1.10, 9.43; Table 1). No other symptom was significantly associated with the adjusted odds of GI bleed.

Discussion: The incidence of GI bleed within 12 months of COVID-19 diagnosis in the ED was low. Abdominal pain at the time of diagnosis was associated with greater odds for a GI bleed. The potential role of GI prophylaxis to prevent GI bleeding in this patient population warrants further study.


Disclosures:


Vincent J. Maffei, MD, PhD, Robert Dorrell, MD, Elizabeth T.. Jensen, MPH, PhD, Steven Clayton, MD. P2030 - SARS-CoV-2 Gastrointestinal Symptoms and One-Year Risk for Gastrointestinal Bleed: A Retrospective Cohort Study, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.