Twice The Risk From COVID-19 By Using A Proton Pump Inhibitor
The American Journal of Gastroenterology recently reported that, depending on dose, the use of proton pump inhibitors could increase risk of contracting COVID-19.
Proton-pump inhibitors are a popular class of drugs commonly used to treat GERD, peptic ulcers, and H. pylori infection. Prilosec, Prevacid and Nexium are among the most common brands, which are used by 50+ million Americans. They work by reducing the production of acid by the body’s acid pumps.
Dr. Christopher V. Almario found that using PPIs, and in particular using them for two daily doses, produces an increased association with positive COVID-19 reports. Almario, from the Department of Medicine at Los Angeles’ Cedars-Sinai Medical Center, went on to say that these positive reports remained after several variables had been taken into account, such as lifestyle, clinician, and sociodemographics. In an interview with Healio Gastroenterology, Almario said that their findings had emphasized the need to use PPIs only when there was a clinical necessity, and that the patient should always use the lowest effective dose.
Between May 3 to June 24, 2020, online research was conducted through a survey of 53,130 patients. The study aimed to determine whether the use of PPIs increased the likelihood of COVID-19 among Americans living in community-dwellings. To control for confounding factors that could contribute to reasons why more COVID-19 results might be found in these populations, the researches used multivariable logistic regression, a standard for isolating the factor under research.
Of the patients surveyed, 3,386 tested positive for COVID-19. Researchers observed occurrences in reporting positive COVID-19 results in the following groups compared to patients who did not use PPIs:
- Patients using PPIs once daily (OR = 2.15; 95% CI, 1.9–2.44)
- Patients using PPIs twice daily (OR = 3.67; 95% CI, 2.93–4.6)
- Patients taking H2RAs (histamine-2 receptor antagonists) – (no elevated risk)
Of the 3386 positive results, 3,267 patients were symptomatic, 647 claimed to experience new onsets of nausea, diarrhea & vomiting, and abdominal pain. Regression analysis showed that there was a lower chance of COVID-19 symptoms presenting in patients who had a lower dosage of PPI (n = 266, 10.9%; OR = 0.62; 95% CI, 0.49–0.78), compared to patients that did not use PPIs (n = 297, 39.5%).
Cedars-Sinai Medical Center’s professor-in-residence Dr. Brennan Spiegel clarified that the study results did not mean that patients using PPIs should cease their medicine. Spiegel went on to tell Healio Gastroenterology that PPIs are valid and that the benefits of using them outweigh the risk in the majority of cases. Spiegel continued by stressing that, as with any other medicine, the dosage rates of PPI should be the lowest possible effective level, and in line with best-practice procedures. An alternative treatment for acid-related conditions that should be considered is the use of H2RAs, Spiegel recommended