Gastrointestinal bleeding as a complication of Covid-19

Delipetrova, Natali and Lazarevski, Martin and Zikova, Radmila and Mihailov, Marjan and Kukusheva, Ana and Eftimova, Biljana and Mojsova, Maja and Trojikj, Tatjana (2021) Gastrointestinal bleeding as a complication of Covid-19. In: Current topics in anesthesiology, 19-21 Nov 2021, Online.

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Abstract

Introduction: COVID-19 is a disease caused by the SARS-CoV-2 virus that has spread to
pandemic proportions, mostly due to the primary respiratory symptoms: cough, fever, and
shortness of breath. Gastrointestinal symptoms are also uncommon: nausea, vomiting, diarrhea,
and abdominal pain.
Material and methods: In our case, a patient at the age of 69, a proven carrier of SARS-CoV-2
with PCR test, referred by the Infectious Diseases Department where he was hospitalized for 7
days due to fever, malaise and shortness of breath - with lung-proven CT finding: a confluent
zone of ground-glass opacification in the apicoposterior segment of the lower lobe on the right,
as well as several discrete smaller bilateral zones in addition to viral pneumonia, which on
control CT after 5 days were described as pneumonia in progression. Due to the deterioration of
vital parameters, primarily oxygen saturation, he was transferred to Covid - intensive care unit.
There he was treated with continuous oxygen support, with facial oxygen mask, non-rebreathing
mask, as well as CPAP (Continuous positive airway pressure) therapy. Anticoagulant therapy
with low-molecular-weight heparin on the recommendation of a transfusiologist was included in
the therapy due to elevated d-dimer values. On the 10th day of treatment in Covid-ICU, the
patient had melena (blood stool) - a sign of upper intestinal bleeding. Due to a decrease in
hemoglobin, the patient recieved substitution with 2 + 2 units of packed red blood cells and 2 + 2
units of fresh frozen plasma. After he was hemodynamically stabilized, a gastroscopy was
performed 2 days later and showed an ulcer of the duodenum bulb with a visible blood vessel at
the bottom, partially covered with fibrin - type Forrest IIa. After 2 days, another gastroscopy was
performed which showed that the lesion was not bleeding - Forrest IIc. After stabilization and
terminating of the bleeding, which was confirmed gastroscopically and clinically, in an improved
state of health, the patient was discharged with a recommendation for therapy and a hygienic-diet
regime.
Conclusion: The treatment of patients with Covid pneumonia may have gastrointestinal bleeding
as a complication, which is a challenge. They can be treated conservatively, but an endoscopic
procedure with appropriate personal protective equipment is necessary to determine the
etiological cause.
Key words: COVID-19, gastrointestinal bleeding, melena.

Item Type:	Conference or Workshop Item (Poster)
Subjects:	Medical and Health Sciences > Clinical medicine
Divisions:	Faculty of Medical Science
Depositing User:	Assoc.Prof Biljana Eftimova
Date Deposited:	11 Mar 2022 10:35
Last Modified:	11 Mar 2022 10:35
URI:	https://eprints.ugd.edu.mk/id/eprint/29588

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