TY - JOUR T1 - Gastrointestinal mucosal damage in patients with COVID-19 undergoing endoscopy: an international multicentre study JF - BMJ Open Gastroenterology JO - BMJ Open Gastro DO - 10.1136/bmjgast-2020-000578 VL - 8 IS - 1 SP - e000578 AU - Giuseppe Vanella AU - Gabriele Capurso AU - Cesare Burti AU - Lorella Fanti AU - Luigi Ricciardiello AU - Andre Souza Lino AU - Ivo Boskoski AU - Michiel Bronswijk AU - Amy Tyberg AU - Govind Krishna Kumar Nair AU - Stefano Angeletti AU - Aurelio Mauro AU - Fabiana Zingone AU - Kofi W. Oppong AU - Daniel de la Iglesia-Garcia AU - Lieven Pouillon AU - Ioannis S. Papanikolaou AU - Pierluigi Fracasso AU - Fabio Ciceri AU - Patrizia Rovere-Querini AU - Carolina Tomba AU - Edi Viale AU - Leonardo Henry Eusebi AU - Maria Elena Riccioni AU - Schalk van der Merwe AU - Haroon Shahid AU - Avik Sarkar AU - Jin Woo (Gene) Yoo AU - Emanuele Dilaghi AU - R. Alexander Speight AU - Francesco Azzolini AU - Francesco Buttitta AU - Serena Porcari AU - Maria Chiara Petrone AU - Julio Iglesias-Garcia AU - Edoardo V. Savarino AU - Antonio Di Sabatino AU - Emilio Di Giulio AU - James J. Farrell AU - Michel Kahaleh AU - Philip Roelandt AU - Guido Costamagna AU - Everson Luiz de Almeida Artifon AU - Franco Bazzoli AU - Per Alberto Testoni AU - Salvatore Greco AU - Paolo Giorgio Arcidiacono Y1 - 2021/02/01 UR - http://bmjopengastro.bmj.com//content/8/1/e000578.abstract N2 - Background Although evidence suggests frequent gastrointestinal (GI) involvement during coronavirus disease 2019 (COVID-19), endoscopic findings are scarcely reported.Aims We aimed at registering endoscopic abnormalities and potentially associated risk factors among patients with COVID-19.Methods All consecutive patients with COVID-19 undergoing endoscopy in 16 institutions from high-prevalence regions were enrolled. Mann-Whitney U, χ2 or Fisher’s exact test were used to compare patients with major abnormalities to those with negative procedures, and multivariate logistic regression to identify independent predictors.Results Between February and May 2020, during the first pandemic outbreak with severely restricted endoscopy activity, 114 endoscopies on 106 patients with COVID-19 were performed in 16 institutions (men=70.8%, median age=68 (58–74); 33% admitted in intensive care unit; 44.4% reporting GI symptoms). 66.7% endoscopies were urgent, mainly for overt GI bleeding. 52 (45.6%) patients had major abnormalities, whereas 13 bled from previous conditions. The most prevalent upper GI abnormalities were ulcers (25.3%), erosive/ulcerative gastro-duodenopathy (16.1%) and petechial/haemorrhagic gastropathy (9.2%). Among lower GI endoscopies, 33.3% showed an ischaemic-like colitis.Receiver operating curve analysis identified D-dimers >1850 ng/mL as predicting major abnormalities. Only D-dimers >1850 ng/mL (OR=12.12 (1.69–86.87)) and presence of GI symptoms (OR=6.17 (1.13–33.67)) were independently associated with major abnormalities at multivariate analysis.Conclusion In this highly selected cohort of hospitalised patients with COVID-19 requiring endoscopy, almost half showed acute mucosal injuries and more than one-third of lower GI endoscopies had features of ischaemic colitis. Among the hospitalisation-related and patient-related variables evaluated in this study, D-dimers above 1850 ng/mL was the most useful at predicting major mucosal abnormalities at endoscopy.Trial registration number ClinicalTrial.gov (ID: NCT04318366). ER -