PPIs and Beyond : A Framework for Managing Anticoagulation-Related Gastrointestinal Bleeding in the Era of COVID-19

Coronavirus disease of 2019 (COVID-19) can be associated with high morbidity and mortality; patients with severe clinical manifestations may develop significant coagulopathy as well as unexpected thromboembolic complications. In response, centers are increasingly treating selected patients with intermediate-dose prophylactic or even therapeutic dose anticoagulation in order to prevent potentially catastrophic thrombotic complications. With this changing practice, the authors suspect that inpatient gastrointestinal consult teams across the country will be frequently managing COVID-19 patients with gastrointestinal bleeding (GIB). In order to reduce potentially avoidable hospital readmissions for GIB while improving patient outcomes, it is imperative to appropriately risk-stratify patients prior to initiation of anticoagulation. In this review, we discuss how to appropriately identify high-risk patients for GIB and how to mitigate GIB risk with proton-pump inhibitor co-therapy, medication reconciliation, and Helicobacter pylori testing and treating in this complex and morbid population.

Media Type:

Electronic Article

Year of Publication:

2020

Contained In:

Digestive diseases and sciences - Vol. 65, No. 8 (2020), p. 2181-2186

Language:

English

Contributors:

Patel, Parita
Sengupta, Neil

Links:

Volltext

Keywords:

*Blood Coagulation Disorders
*Gastrointestinal Hemorrhage
Anticoagulants
Anticoagulation
Betacoronavirus
COVID-19
Chemoprevention
Coronavirus Infections
Gastrointestinal bleeding
Humans
Journal Article
Pandemics
Pneumonia, Viral
Proton Pump Inhibitors
Review
Risk Adjustment
Thrombosis

Notes:

Date Completed 31.07.2020

Date Revised 09.09.2020

published: Print

Citation Status MEDLINE

Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Physical Description:

Online-Ressource

doi:

10.1007/s10620-020-06408-x

PMID:

32537704

PPN (Catalogue-ID):

NLM312066597