{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T16:32:12Z","timestamp":1788971532614,"version":"build-2803163510"},"reference-count":31,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T00:00:00Z","timestamp":1696204800000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:label\/><jats:p>Little data is available regarding the incidence of gastrointestinal bleeding in adults hospitalized with COVID\u201019 infection and the influence of patient comorbidities and demographics, COVID\u201019 therapies, and typical medications used.\u00a0In this retrospective study, we utilized the National COVID Cohort Collaborative to investigate the primary outcome of the development of gastrointestinal bleeding in 512\u2009467 hospitalized US adults (age &gt;18 years) within 14 days of a COVID\u201019 infection and the influence of demographics, comorbidities, and selected medications.\u00a0Gastrointestinal bleeding developed in 0.44% of patients hospitalized with COVID\u201019. Comorbidities associated with gastrointestinal bleeding include peptic ulcer disease (adjusted odds ratio [aOR] 10.2), obesity (aOR 1.27), chronic kidney disease (aOR 1.20), and tobacco use disorder (aOR 1.28). Lower risk of gastrointestinal bleeding was seen among women (aOR 0.76), Latinx (aOR 0.85), and vaccinated patients (aOR 0.74). Dexamethasone alone or with remdesivir was associated with lower risk of gastrointestinal bleeding (aOR 0.69 and aOR 0.83, respectively). Remdesivir monotherapy was associated with upper gastrointestinal bleeding (aOR 1.25). Proton pump inhibitors were more often prescribed in patients with gastrointestinal bleeding, likely representing treatment for gastrointestinal bleeding rather than a risk factor for its development.\u00a0In adult patients hospitalized with COVID\u201019, the use of dexamethasone alone or in combination with remdesivir is negatively associated with gastrointestinal bleeding. Remdesivir monotherapy is associated with increased risk of upper gastrointestinal bleeding.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmv.29100","type":"journal-article","created":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T05:18:46Z","timestamp":1696310326000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Associations between COVID\u201019 therapies and inpatient gastrointestinal bleeding: A multisite retrospective study"],"prefix":"10.1002","volume":"95","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9438-0224","authenticated-orcid":false,"given":"Noah A.","family":"Wiedel","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Division of Hospital Medicine University of Nebraska Medical Center  Omaha Nebraska USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harlan","family":"Sayles","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Nebraska Medical Center  Omaha Nebraska USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Larson","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine College of Medicine, University of Nebraska Medical Center  Omaha Nebraska USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jana L.","family":"Wardian","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Hospital Medicine University of Nebraska Medical Center  Omaha Nebraska USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Hewlett","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Gastroenterology and Hepatology University of Nebraska Medical Center  Omaha Nebraska USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"McClay","sequence":"additional","affiliation":[{"name":"Department of Health Management &amp; Informatics University of Missouri School of Medicine  Columbia Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Ge","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology and Hepatology University of California at San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfred Jerrod","family":"Anzalone","sequence":"additional","affiliation":[{"name":"Department of Neurological Sciences University of Nebraska Medical Center  Omaha Nebraska USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"The N3C consortium","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,10,2]]},"reference":[{"issue":"9","key":"e_1_2_13_2_1","article-title":"An interactive web\u2010based dashboard to track COVID\u201019 in real time","volume":"20","author":"Dong E","year":"2020","journal-title":"Lancet Infect Dis"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.26836"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinre.2020.07.025"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2011.14"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000000997"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jfma.2018.10.007"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000001872"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2014.11.007"},{"key":"e_1_2_13_10_1","doi-asserted-by":"crossref","DOI":"10.3389\/fphar.2010.00126","article-title":"Risk of upper gastrointestinal bleeding in a cohort of new users of low\u2010dose ASA for secondary prevention of cardiovascular outcomes","volume":"1","author":"Cea Soriano L","year":"2010","journal-title":"Front Pharmacol"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hjc.2020.07.003"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpg.2019.04.003"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpg.2012.01.011"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2007764"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.171361"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2031994"},{"key":"e_1_2_13_17_1","article-title":"Baricitinib and dexamethasone for hospitalized patients with COVID\u201019","volume":"10","author":"Calabrese LH","year":"2021","journal-title":"Cleve Clin J Med"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2021436"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0040-1715456"},{"key":"e_1_2_13_20_1","article-title":"Effectiveness of therapeutic heparin versus prophylactic heparin on death, mechanical ventilation, or intensive care unit admission in moderately ill patients with covid\u201019 admitted to hospital: RAPID randomised clinical trial","volume":"375","author":"Sholzberg M","year":"2021","journal-title":"BMJ"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2021.6203"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2103417"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2020.08.035"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000000805"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001885"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/jamia\/ocaa196"},{"key":"e_1_2_13_27_1","unstructured":"PfaffE.COVID\u201019 Phenotype Documentation Version 4.0.N3C Phenotype & Data Acquisition Workstream.2022.https:\/\/github.com\/National-COVID-Cohort-Collaborative\/Phenotype_Data_Acquisition\/wiki\/Latest-Phenotype"},{"issue":"1","key":"e_1_2_13_28_1","first-page":"39","article-title":"Higher hospitalization and mortality rates among SARS\u2010CoV\u20102 infected persons in Rural America","volume":"39","author":"Anzalone AJ","year":"2023","journal-title":"medRxiv"},{"key":"e_1_2_13_29_1","unstructured":"PfaffE.N3C Phenotype & Data Acquisition Workstream.2021.https:\/\/github.com\/National-COVID-Cohort-Collaborative\/Phenotype_Data_Acquisition"},{"key":"e_1_2_13_30_1","unstructured":"OHDSI.The Book of OHDSI: Observational Health Data Sciences and Informatics.2019."},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/wics.147"},{"key":"e_1_2_13_32_1","unstructured":"SchloerkeB CookD LarmarangeJ BriatteF MarbachM ThoenE et al. Extension to \u2018ggplot2\u2019. R package version 2.1.2. 2022. (Unpublished Material)."}],"container-title":["Journal of Medical Virology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jmv.29100","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,2]],"date-time":"2024-08-02T12:32:34Z","timestamp":1722601954000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jmv.29100"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10]]},"references-count":31,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2023,10]]}},"alternative-id":["10.1002\/jmv.29100"],"URL":"https:\/\/doi.org\/10.1002\/jmv.29100","archive":["Portico"],"relation":{},"ISSN":["0146-6615","1096-9071"],"issn-type":[{"value":"0146-6615","type":"print"},{"value":"1096-9071","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10]]},"assertion":[{"value":"2023-05-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-09-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e29100"}}