Proton pump inhibitors and gastrointestinal symptoms among patients with COVID-19 infection
Hafez Al-Momani, Iman Aolaymat
Annals of Medicine, doi:10.1080/07853890.2024.2355581
Introduction: the administration of proton pump inhibitors (PPis) is anticipated to elevate an individual's susceptibility to enteric infections as a result of altering the gut flora. the influence of PPis on the clinical manifestation of severe acute respiratory syndrome coronavirus 2 (saRs-coV-2) is still uncertain. this study aims to investigate the impact of PPi usage on the clinical manifestation of cOViD-19, namely its gastrointestinal symptoms. Methods: this is a cross-sectional cohort study involving cOViD-19 patients. Patients were interviewed using a predesigned questionnaire that asked about their demographics, clinical manifestations of cOViD-19 infection, and the extent and type of PPis in use. PPi usage was confirmed by reviewing patients' electronic medical records. the primary outcome was to establish any association between the use of PPi and the symptoms and clinical presentation of cOViD-19. Results: Out of a total of 254 participants, 69 (27.2%) were considered PPi users. Patients who were on PPi medications reported a significantly lower rate of myalgia (27.5% vs 51.9%; p = 0.0006) and heartburn (5.7% vs 15.6%; p = 0.03) but had a significantly higher rate of abdominal pain (27.5% vs 13.5%; p = 0.001) and diarrhoea (28.9% vs 14.5%, p = 0.02) when compared to those who were not using PPis. Patients on PPis were also shown to have significantly higher odds of developing diarrhoea (OR 2.0, 95% ci: 1.08 to 3.93, p = 0.02) and abdominal pain (OR 2.0, 95% ci: 1.22 to 3.93, p = 0.03), but a lower risk of developing myalgia (OR 0.5, 95% ci: 0.3 to 0.9, p = 0.02) when compared to non-PPi users. Conclusion: this study shows that the use of PPis could impact cOViD-19 clinical presentation toward more gastrointestinal manifestations. Further studies investigating the link between other acid suppression medications and cOViD-19 manifestations and severity should be carried out.
Ethical approval and consent to participate this study was granted ethical approval by the hashemite University and the Prince hamza hospital's ethics service committee with reference number 5/3/2020/2021. all experimental protocols were approved by hashemite University and the Prince hamza hospital's ethics service committee. all of the study participants have provided written informed consent prior to their induction into the study. all the methods were carried out in accordance with the relevant guidelines and regulations.
Author contributions h. M was responsible for the study design, he analyzed data, prepared figures and co-wrote the manuscript. i. a: responsible for data analysis and co-wrote the manuscript.
Consent to publication
Not applicable
Disclosure statement No potential conflict of interest was reported by the author(s).
Funding hashemite University (Jordan) provides the funding source for this research, h al-Momani received financial support from the Department of scientific research at the Jordanian hashemite University.
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