Gastric ulcerations in COVID-19: an ominous sign?

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Abstract
Gastrointestinal bleeding (GIB) is often reported in patients with COVID-19, with a reported incidence of 3% in a recent prospective cohort study of hospitalised patients with COVID-19. This study also reported that GIB is associated with an increase in mortality in patients with COVID-19.1 The most common causes of bleeding observed on esophagogastroduodenoscopy (EGD) were gastroduodenal ulceration1 and esophagitis.2 We present three cases of patients with COVID-19 who developed massive GIB from gastric ulcers during the course of their hospitalisation despite being on proton-pump inhibitor prophylaxis. All these three patients ultimately had a fatal outcome, thereby reiterating the poor prognosis associated with gastric ulceration. We briefly describe the clinical course and the associated EGD findings in these patients.