Mortality Rate in Upper Gastrointestinal Bleeding Associated with Anti-Thrombotic Therapy Before and During Covid-19 Pandemic

Petrica Popa,1,* Sevastita Iordache,1,* Dan Nicolae Florescu,1,* Vlad Florin Iovanescu,1,* Alexandru Vieru,2 Valentin Barbu,2 Maria-Cristina Bezna,3,* Dragos Ovidiu Alexandru,4,* Bogdan Silviu Ungureanu,1,* Sergiu Marian Cazacu1,* 1Gastroenterology Department, University of Medicine and Pharmacy Craiova, Craiova, Dolj County, Romania; 2Gastroenterology Department, Clinical Emergency County Hospital Craiova, Craiova, Dolj County, Romania; 3Cardiology Department, Clinical Emergency County Hospital Craiova, Craiova, Romania; 4Department of Medical Informatics and Statistics, University of Medicine and Pharmacy Craiova, Craiova, Dolj County, Romania*These authors contributed equally to this workCorrespondence: Dan Nicolae Florescu, University of Medicine and Pharmacy Craiova, Gastroenterology Department, Petru Rares Street No. 2-4, Craiova, Dolj County, 200349, Romania, Tel +40723377004, Fax +40251426688, Email nicku.dan@gmail.comIntroduction: During the last few years, a progressive higher proportion of patients have had upper gastrointestinal bleeding (UGIB) related to antithrombotic therapy. The introduction of direct oral anticoagulant (DOAC) and COVID-19 pandemic may change the incidence, mortality, and follow-up, especially in patients at high risk of bleeding.Patients and Methods: We studied the use of anti-thrombotic therapy (AT) in patients with upper gastrointestinal bleeding for 5 years (January 2017–December 2021) including Covid-19 pandemic period (March 2020–December 2021). We analyzed mortality rate, rebleeding rate and need for transfusion in patients with AT therapy compared with those without AT therapy and risk factors for mortality, and also the incidence of gastrointestinal bleeding in patients admitted for COVID-19 infection.Results: A total of 824 patients were admitted during Covid-19 pandemic period and 1631 before pandemic period; a total of 426 cases of bleeding were r