Endoscopic hemostasis in erosive and ulcerative gastroduodenal bleeding in patients with COVID-associated pneumonia

Introduction. Covid-associated endothelial damage and dysregulation hemostasis causes hypercoagulation, DIC syndrome and can lead to erosive and ulcerative damage of the mucous membrane of the stomach and duodenum. Basic therapy of patients with COVID-19 includes nonsteroidal anti-inflammatory and hormonal drugs, contributing to the destruction of the mucous membrane of the gastrointestinal tract, and anticoagulants that cause or increase bleeding. Objective. Analysis and comparison of endoscopic hemostasis from the upper gastrointestinal tract in patients with COVID-19-associated pneumonia.
Material and methods. A retrospective study of the results of treatment of 72 patients with Covid-pneumonia complicated by erosive and ulcerative gastroduodenal bleeding was performed. There were 2 groups: I – 45 patients (62,5 %) who underwent two-stage hemostasis. II – 27 patients (37,5 %) who underwent three-stage hemostasis.
Results. Recurrence of bleeding was recorded only in group I in 3 patients (6,65 %) with Forrest 1B. All these patients underwent a second three-stage hemostasis.
Conclusion. Three-stage endoscopic hemostasis, including submucosal infiltration of the bleeding vessel area with epinephrine solution, argonoplasmic coagulation of the vessel and application of fibrin-based glue, in most cases prevents recurrence of bleeding. The study requires more observations.

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