Objective The COVID-19 pandemic has placed increased strain on healthcare systems worldwide with enormous reorganisation undertaken to support ‘COVID-centric’ services. Non-COVID-19 admissions reduced secondary to public health measures to halt viral transmission. We aimed to understand the impact of the response to COVID-19 on the outcomes of upper gastrointestinal (UGI) bleeds. Design/methods A retrospective observational multicentre study comparing outcomes following endoscopy for UGI bleeds from 24 March 2020 to 20 April 2020 to the corresponding dates in 2019. The primary outcome was in-hospital survival at 30 days with secondary outcomes of major rebleeding within 30 days postprocedure and intervention at the time of endoscopy. Results 224 endoscopies for 203 patients with UGI bleeds were included within this study. 19 patients were diagnosed with COVID-19. There was a 44.4% reduction in the number of procedures performed between 2019 and 2020. Endoscopies performed for UGI bleeds in the COVID-19 era were associated with an adjusted reduced 30-day survival (OR 0.25, 95% CI 0.08–0.67). There was no increased risk of major rebleeding or interventions during this era. Patients with COVID-19 did not have reduced survival or increased complication rates. Conclusion Endoscopy for UGI bleeds in the COVID-19 era is associated with reduced survival. No clear cause has been identified but we suspect that this is a secondary effect of the response to the COVID-19 pandemic. Urgent work is required to encourage the public to seek medical help if required and to optimise patient pathways to ensure that the best possible care is provided. Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information. De-identified participant data is stored on an encrypted password-protected computer in the Institute of Liver Studies, King’s College Hospital. Data is available on request from Dr OD Tavabie at oliver.tavabie@nhs.net.

中文翻译：

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COVID-19 时代上消化道出血内镜检查后生存率降低是应对全球大流行的次要影响：一项回顾性队列研究

目标 COVID-19 大流行给全球医疗保健系统带来了更大的压力，并进行了大规模重组以支持“以 COVID 为中心”的服务。非 COVID-19 的入院次要减少是由于采取了阻止病毒传播的公共卫生措施。我们旨在了解对 COVID-19 的反应对上消化道 (UGI) 出血结果的影响。设计/方法 一项回顾性观察性多中心研究，比较从 2020 年 3 月 24 日至 2020 年 4 月 20 日至 2019 年相应日期的内镜检查后 UGI 出血的结果。主要结果是 30 天内的住院生存率，次要结果是 30 天内的主要再出血内窥镜检查时的术后和干预。结果 本研究纳入了 203 名 UGI 出血患者的 224 次内镜检查。19 名患者被诊断出患有 COVID-19。2019 年至 2020 年期间进行的手术数量减少了 44.4%。在 COVID-19 时代为 UGI 出血进行的内镜检查与调整后的 30 天生存率降低有关（OR 0.25，95% CI 0.08–0.67）。在这个时代，严重再出血或干预的风险没有增加。COVID-19 患者的生存率并未降低或并发症发生率增加。结论 COVID-19 时代 UGI 出血的内镜检查与生存率降低有关。尚未确定明确的原因，但我们怀疑这是应对 COVID-19 大流行的次要影响。需要紧急开展工作，鼓励公众在需要时寻求医疗帮助，并优化患者路径，以确保提供最佳护理。可根据合理要求提供数据。所有与研究相关的数据都包含在文章中或作为补充信息上传。去识别的参与者数据存储在国王学院医院肝脏研究所的加密密码保护计算机上。OD Tavabie 博士可通过 Oliver.tavabie@nhs.net 索取数据。