Highlights UGIB has a prevalence of 0.47% in non-ICU COVID-19 patients and peptic disease is the most common finding. Half of patients were managed conservatively or with delayed endoscopy. This is the first report that evaluates incidence of UGIB in COVID-19 patients. Conservative management and delayed endoscopy could be a successful option in patients with significant respiratory impairment.

Introduction The aim of this study was to provide an external validation of bowel ultrasound (US) predictors of activity in ulcerative colitis (UC) and quantitative Milan Ultrasound Criteria (MUC). Methods Forty-three consecutive patients with UC (16 in endoscopic remission and 27 with endoscopic activity) underwent bowel US and colonoscopy in a tertiary referral inflammatory bowel disease unit. Results A MUC score >6.2 discriminated patients with active versus non-active UC with a sensitivity of 0.85 (95% confidence interval (CI) 0.66‒0.96), specificity of 0.94 (95% CI 0.70‒0.99) and an area under the curve of 0.902 (95% CI 0.772‒0.971) in complete agreement with the derivation study. Conclusion The external validation of MUC confirms that it is an accurate tool for assessing disease activity in patients with UC.

This article has an accompanying continuing medical education activity, also eligible for MOC credit, on page e122. Learning Objective-Upon completion of this activity, successful learners will be able to list the most common upper endoscopic findings in patients infected with 2019 novel coronavirus (SARS-Cov-2), list the most common lower endoscopic findings in patients infected with SARS-Cov-2; list appropriate PPE for health care providers performing endoscopic evaluation in patients positive or at high risk of SARS-Cov-2; and realize prioritization of endoscopic evaluation of GI bleeding in high-risk patients should be determined by clinical factors and not SARS-Cov-2 status. C oronavirus disease 2019 (COVID-19) is a major worldwide threat caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), rapidly spreading to a global pandemic. As of May 11, 2020, 4,176,346 cases have been reported worldwide, 219,814 in Italy, and of them, 81,871 occurred in the Lombardy region. 1 Although the respiratory manifestations of COVID-19 have been widely described, the impact on the gastrointestinal (GI) system remains less clear. The reported prevalence of digestive symptoms ranges from 3% to 79%, depending on the setting, 2-5 but data on GI endoscopic and histologic findings in COVID-19 patients are lacking. Therefore, the aim of this study is to describe the GI endoscopic and histologic findings in COVID-19 patients.