Role of Famotidine and Other Acid Reflux Medications for SARS-CoV-2: A Pilot Study
Survey of 307 patients in the USA, showing no significant difference in COVID-19 cases with famotidine use.
risk of symptomatic case, 22.0% lower, RR 0.78, p = 0.49, treatment 18 of 80 (22.5%), control 49 of 227 (21.6%), adjusted per study, odds ratio converted to relative risk, multivariable.
recovery time, 36.9% lower, relative time 0.63, p = 0.32, treatment 80, control 227.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Balouch et al., 20 Jan 2021, retrospective, USA, peer-reviewed, 5 authors.
Abstract: ARTICLE IN PRESS
Role of Famotidine and Other Acid Reflux Medications for
SARS-CoV-2: A Pilot Study
*Bailey Balouch, *Swetha Vontela, *Heather Yeakel, †Ghiath Alnouri, and †,‡Robert T. Sataloff, *yPhiladelphia, and
Summary: Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the
coronavirus-19 disease (COVID-19) pandemic. The H-2 blocker famotidine has been suggested as an FDAapproved drug that could potentially be repurposed for treatment of COVID-19. Famotidine has since been shown
to improve patient outcomes and reduce symptom severity in patients acutely ill with COVID-19. Other studies
have suggested that proton pump inhibitors (PPIs) might have an association with COVID-19.
Objective. The purpose of the present study was to determine whether famotidine or any other antireﬂux medications have a prophylactic or detrimental effect for SARS-CoV-2 infection when taken regularly for the management
of acid reﬂux.
Methods. An anonymous, web-based survey was distributed via email to adult otolaryngology patients to collect
demographic data, past medical history, medication history, incidence of symptoms associated with COVID-19,
potential exposure to SARS-CoV-2, and results of any PCR or serological testing. Associations between reﬂux
medications and incidence of COVID-19 cases were analyzed. Statistical analysis was performed using SPSS. Chisquare with Fisher’s exact test, Point-Biserial correlation, Kendall’s-tau-b, independent samples t test, and the
Mann-Whitney U test were used as appropriate. A binary logistic regression model was ﬁt to determine probability
of COVID-19 cases after adjustment for other risk factors.
Results. There were 307 patients who responded to the survey. The average age of respondents was 52.63 § 17.03.
Famotidine use was not associated with incidence of laboratory-conﬁrmed (P= 0.717) or symptomatically suspected
(P= 0.876) COVID-19. No other reﬂux medications were found to be signiﬁcant predictors for laboratory-conﬁrmed
or suspected COVID-19 (P> 0.05). Younger age (odds ratio [OR] = 1.043, 95% CI: 1.020−1.065, P< 0.001), high risk
obesity (OR = 4.005, 95% CI: 1.449−11.069, P= 0.007), and use of a corticosteroid nasal spray (OR = 3.529, 95% CI:
1.352−9.211, P= 0.010) were signiﬁcant predictors for symptomatically suspected COVID-19 cases.
Conclusions. There was no association between incidence of COVID-19 and use of reﬂux medications, including
famotidine at doses used orally to manage reﬂux and high dose PPIs. Reﬂux medications did not protect against or
increase the risk of COVID-19.
Key Words: COVID-19−SARS-CoV-2−Famotidine−Proton pump inhibitor−Intranasal corticosteroid−Age
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