Universität zu Köln

Allo, Gabriel ORCID: 0000-0001-7568-7431, Quickert, Stefanie ORCID: 0009-0009-9391-4111, Große, Karsten, Baysal, Sidar ORCID: 0009-0001-5769-4096, Nierhoff, Dirk ORCID: 0000-0001-7297-2675, Neumann-Haefelin, Christoph ORCID: 0000-0001-7351-1387, Schramm, Christoph, Bruns, Tony ORCID: 0000-0002-5576-6914, Reuken, Philipp Alexander ORCID: 0000-0002-7696-475X and Bürger, Martin ORCID: 0000-0002-8940-7696 (2025). Acute Variceal Bleeding During the SARS-CoV-2 Pandemic: A National Multicenter Observational Study. Journal of Clinical Medicine, 14 (17). MDPI. ISSN 2077-0383

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Abstract

[Artikel-Nr. 6166] Background: The COVID-19 pandemic disrupted healthcare systems globally, raising concerns about its negative impact on patients with chronic liver diseases by contributing to hepatic decompensations such as acute variceal bleeding (AVB). This study aimed to evaluate the impact of the COVID-19 pandemic on clinical outcomes in cirrhotic patients with AVB in Germany. Methods: This retrospective national multicenter study compared patients with cirrhosis and AVB treated at four tertiary care centers in Germany before (2016–2020) and during the pandemic (2020–2022). The primary endpoint was 6-week mortality, and secondary outcomes included infections, transfusion requirement and rebleeding. Results: The baseline characteristics of the 247 patients were largely comparable between the two groups, however metabolic dysfunction-associated steatotic liver disease was more prevalent during the pandemic compared to the pre-pandemic period (12.5% vs. 4.8%, p = 0.048). Only one patient tested positive for SARS-CoV-2. Six-week mortality (32.2% vs. 30.1%; p = 0.767) and rebleeding rates (22.8% vs. 22.3%; p = 1.000) did not differ significantly between groups. Interestingly, intubation rates, length of stay on the intensive care unit, post AVB infection rates and types of infection were also comparable (all p > 0.05), while transjugular intrahepatic portosystemic shunt placement (TIPS) after bleeding was performed more frequently during the pandemic (23.2% vs. 11.3%, p = 0.019). Conclusions: Relevant patient-related AVB outcomes were unaffected during the COVID-19 pandemic. These findings suggest the resilience of critical AVB management practices in German tertiary centers. The increased use of TIPS and MASLD prevalence during the pandemic may reflect evolving clinical practice and patient profiles warranting further investigation.

Item Type:	Article
Creators:	Creators Email ORCID ORCID Put Code Allo, Gabriel UNSPECIFIED https://orcid.org/0000-0001-7568-7431 UNSPECIFIED Quickert, Stefanie UNSPECIFIED https://orcid.org/0009-0009-9391-4111 UNSPECIFIED Große, Karsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Baysal, Sidar UNSPECIFIED https://orcid.org/0009-0001-5769-4096 UNSPECIFIED Nierhoff, Dirk UNSPECIFIED https://orcid.org/0000-0001-7297-2675 UNSPECIFIED Neumann-Haefelin, Christoph UNSPECIFIED https://orcid.org/0000-0001-7351-1387 UNSPECIFIED Schramm, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Bruns, Tony UNSPECIFIED https://orcid.org/0000-0002-5576-6914 UNSPECIFIED Reuken, Philipp Alexander UNSPECIFIED https://orcid.org/0000-0002-7696-475X UNSPECIFIED Bürger, Martin UNSPECIFIED https://orcid.org/0000-0002-8940-7696 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-800602
Identification Number:	10.3390/jcm14176166
Journal or Publication Title:	Journal of Clinical Medicine
Volume:	14
Number:	17
Number of Pages:	10
Date:	31 August 2025
Publisher:	MDPI
ISSN:	2077-0383
Language:	English
Faculty:	Faculty of Medicine
Divisions:	Faculty of Medicine > Innere Medizin > Klinik für Gastroenterologie und Hepatologie
Subjects:	Medical sciences Medicine
Uncontrolled Keywords:	Keywords Language upper gastrointestinal bleeding ; cirrhosis ; portal hypertension ; COVID-19 ; pandemic ; acute variceal bleeding English
['eprint_fieldname_oa_funders' not defined]:	Publikationsfonds UzK
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/80060