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Influence of COVID-19 on patients with esophageal varices under prophylactic endoscopic band ligation therapy

2023Journal article Open access
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dc.contributor.authorCraciun, Ana
dc.contributor.authorBotto, Inês
dc.contributor.authorLopes, Joao
dc.contributor.authorMoura, Miguel
dc.contributor.authorCarvalhana, Sofia
dc.contributor.authorCortez-Pinto, Helena
dc.contributor.authorMarinho, Rui
dc.date.accessioned2024-05-29T14:53:32Z
dc.date.available2024-05-29T14:53:32Z
dc.date.issued2023
dc.description© 2023 The Author(s). Published by S. Karger AG, Basel. Open Access License. This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC). Usage and distribution for commercial purposes requires written permission.pt_PT
dc.description.abstractBackground and objectives: Endoscopic band ligation (EBL) plays a critical role in patients with clinically significant portal hypertension, as variceal eradication (VE) is essential to prevent further variceal upper gastrointestinal bleeding (GI). The emergence of COVID-19 has led to a dramatic reduction in endoscopic activity. Our study aimed to evaluate the effect of COVID-19 on VE, GI, and 6-month mortality of patients treated with prophylactic EBL therapy. In addition, our goal was to identify the risk factors for our proposed outcomes. Methods: A single-center retrospective cohort study included patients with esophageal varices treated with prophylactic EBL therapy between 2017 and 2021. To demonstrate the impact of COVID-19 on two independent groups on prophylactic EBL therapy with 1 year of follow-up, March 2019 was selected as the cut-off date. Clinical, laboratory, and endoscopic data were recovered from electronic reports. Results: Ninety-seven patients underwent 398 prophylactic EBL sessions, 75 men (77.3%) with mean age 59 ± 12 years. Most achieved VE (60.8%), 14.4% had GI bleeding post-therapy, and 15.5% died at 6 months. The rate of variceal obliteration was significantly lower in the pandemic group (40.9% vs. 77.4% in the pre-pandemic group, p = 0.001). Mean number of EBL sessions and pandemic group were independently associated with incomplete VE, while MELD-Na, portal vein thrombosis and failed VE were identified as risk factors associated with mortality at 6 months. Conclusions: Almost 60% of patients in the pandemic group failed to eradicate esophageal varices. Failure to achieve this result conferred a higher risk of GI bleeding and death at 6 months, the latter also significantly associated with the MELD-Na score and portal vein thrombosis. Our study is among the first to demonstrate the impact of COVID-19 in patients receiving prophylactic EBL therapy.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationGE Port J Gastroenterol. 2023 Jul 19;31(3):182-190pt_PT
dc.identifier.doi10.1159/000531135pt_PT
dc.identifier.eissn2387-1954
dc.identifier.issn2341-4545
dc.identifier.urihttp://hdl.handle.net/10451/64921
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherKargerpt_PT
dc.relation.publisherversionhttps://karger.com/pjgpt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/pt_PT
dc.subjectCOVID-19pt_PT
dc.subjectEndoscopic band ligationpt_PT
dc.subjectLiver cirrhosispt_PT
dc.subjectVariceal eradicationpt_PT
dc.titleInfluence of COVID-19 on patients with esophageal varices under prophylactic endoscopic band ligation therapypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage9pt_PT
oaire.citation.startPage1pt_PT
oaire.citation.titleGE - Portuguese Journal of Gastroenterologypt_PT
person.familyNameCraciun
person.familyNameMoura
person.familyNamecarvalhana
person.familyNameCortez-Pinto
person.familyNameMarinho
person.givenNameAna
person.givenNameMiguel
person.givenNamesofia
person.givenNameHelena
person.givenNameRui
person.identifier.ciencia-id841C-E5A8-46C4
person.identifier.ciencia-idA01C-0511-C986
person.identifier.ciencia-id531A-BB6A-AA45
person.identifier.orcid0000-0001-9778-3686
person.identifier.orcid0000-0002-0314-3926
person.identifier.orcid0000-0001-6120-2333
person.identifier.orcid0000-0002-8537-8744
person.identifier.orcid0000-0003-1327-3537
person.identifier.scopus-author-id7005027284
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
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relation.isAuthorOfPublication.latestForDiscovery46639b3c-37b8-4aba-ad28-e0cb21e14b34

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