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Interest of Proton Pump Inhibitors in Reducing the Occurrence of COVID-19: A Case-Control Study

May 2020  
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Case -51% Improvement Relative Risk Acetaminophen for COVID-19  Blanc et al.  Prophylaxis Does acetaminophen reduce COVID-19 infections? Retrospective 179 patients in France (March - April 2020) More cases with acetaminophen (not stat. sig., p=0.19) Blanc et al., MDPI AG, May 2020 Favorsacetaminophen Favorscontrol 0 0.5 1 1.5 2+
1st treatment shown to increase risk in November 2020
*, now with p = 0.00000029 from 27 studies, but still recommended in 64 countries.
* From meta analysis with ≥3 studies.
4,400+ studies for 79 treatments.
Retrospective 179 elderly patients in France, showing higher risk of COVID-19 cases with acetaminophen use, without statistical significance.
Acetaminophen is also known as paracetamol, Tylenol, Panadol, Calpol, Tempra, Calprofen, Doliprane, Efferalgan, Grippostad C, Dolo, Acamol, Fevadol, Crocin, and Perfalgan.
risk of case, 51.4% higher, OR 1.51, p = 0.19, treatment 60, control 119, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Blanc et al., 2 May 2020, retrospective, France, preprint, mean age 84.1, 22 authors, study period 2 March, 2020 - 8 April, 2020.
This PaperAcetaminophenAll
Interest of Proton Pump Inhibitors in Reducing the Occurrence of COVID-19: A Case-Control Study
Frederic Blanc, Cedric Waechter, Thomas Vogel, Benoît Schorr, Catherine Demuynck, Catherine Martin-Hunyadi, Maxence Meyer, Denata Mutelica, Nadjiba Bougaa, Samira Fafi-Kremer, Lidia Calabrese, Elise Schmitt, Delphine Imperiale, Catherine Jehl, Alexandre Boussuge, Carmen Suna, François Weill, Alexia Matzinger, Candice Muller, Patrick Karcher, Georges Kaltenbach, Erik Sauleau
Background: COVID-19 is a disease of the elderly as 95% of deaths related to COVID-19 occur in people over 60 years of age. Despite the urgent need for a preventive treatment there are currently no serious leads, other than the vaccination. Objective: To find a preventive treatment of COVID-19 in elderly patients.
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Setting: Robertsau Geriatric Hospital of the University Hospitals of Strasbourg, ' 'France. Patients: 179 elderly patients who had been in contact with the SARS-CoV-2, of whom ' '89 had tested RT-PCR-positive (COVID-pos) for the virus and 90 had tested RT-PCR-negative ' '(COVID-neg). Measurements: Treatments within 15 days prior to RT-PCR (including ' 'antihypertensive drugs, antipsychotics, antibiotics, nonsteroidal anti-inflammatory drugs, ' 'proton pump inhibitors (PPIs), paracetamol, anticoagulant, oral antidiabetics (OADs), ' 'corticosteroids, immunosuppressants), comorbidities, symptoms, laboratory values, and ' 'clinical outcome were all collected using the electronic patient record. Results: COVID-pos ' 'patients more frequently had a history of diabetes (P=.016) and alcoholism (P=.023), a lower ' 'leukocyte count (P=.014) and a higher mortality rate&amp;ndash; 29.2% versus 14.4% ' '&amp;ndash; (P=.014) when compared to COVID-neg patients. Patients on PPIs were 2.3 times ' 'less likely (odds ratio [OR] = 0.4381, 95% confidence interval [CI] [0.2331, 0.8175], ' 'P=.0053) to develop COVID-19 infection, compared to those not on PPIs. No other treatment ' 'decreased or increased this risk. COVID-19 patients on antipsychotics (P=.0013) and OADs ' '(P=.0166) were less likely to die. Limitations: retrospective study. Conclusion: PPIs ' 'treatment lowered the risk of development of COVID-19 infection, and antipsychotics and OADs ' 'decreased the risk of mortality in geriatric patients. If further studies confirm this ' 'finding, PPIs could be used preventatively in the elderly in this pandemic context. Moreover, ' 'OADS and antipsychotics should be tested in clinical trials.</jats:p>', 'DOI': '10.20944/preprints202005.0016.v1', 'type': 'posted-content', 'created': {'date-parts': [[2020, 5, 4]], 'date-time': '2020-05-04T16:19:38Z', 'timestamp': 1588609178000}, 'source': 'Crossref', 'is-referenced-by-count': 5, 'title': 'Interest of Proton Pump Inhibitors in Reducing the Occurrence of COVID-19: A Case-Control Study', 'prefix': '10.20944', 'author': [ {'given': 'Frederic', 'family': 'Blanc', 'sequence': 'first', 'affiliation': []}, {'given': 'Cedric', 'family': 'Waechter', 'sequence': 'additional', 'affiliation': []}, {'given': 'Thomas', 'family': 'Vogel', 'sequence': 'additional', 'affiliation': []}, {'given': 'Benoît', 'family': 'Schorr', 'sequence': 'additional', 'affiliation': []}, {'given': 'Catherine', 'family': 'Demuynck', 'sequence': 'additional', 'affiliation': []}, {'given': 'Catherine', 'family': 'Martin-Hunyadi', 'sequence': 'additional', 'affiliation': []}, {'given': 'Maxence', 'family': 'Meyer', 'sequence': 'additional', 'affiliation': []}, {'given': 'Denata', 'family': 'Mutelica', 'sequence': 'additional', 'affiliation': []}, {'given': 'Nadjiba', 'family': 'Bougaa', 'sequence': 'additional', 'affiliation': []}, {'given': 'Samira', 'family': 'Fafi-Kremer', 'sequence': 'additional', 'affiliation': []}, {'given': 'Lidia', 'family': 'Calabrese', 'sequence': 'additional', 'affiliation': []}, {'given': 'Elise', 'family': 'Schmitt', 'sequence': 'additional', 'affiliation': []}, {'given': 'Delphine', 'family': 'Imperiale', 'sequence': 'additional', 'affiliation': []}, {'given': 'Catherine', 'family': 'Jehl', 'sequence': 'additional', 'affiliation': []}, {'given': 'Alexandre', 'family': 'Boussuge', 'sequence': 'additional', 'affiliation': []}, {'given': 'Carmen', 'family': 'Suna', 'sequence': 'additional', 'affiliation': []}, {'given': 'François', 'family': 'Weill', 'sequence': 'additional', 'affiliation': []}, {'given': 'Alexia', 'family': 'Matzinger', 'sequence': 'additional', 'affiliation': []}, {'given': 'Candice', 'family': 'Muller', 'sequence': 'additional', 'affiliation': []}, {'given': 'Patrick', 'family': 'Karcher', 'sequence': 'additional', 'affiliation': []}, {'given': 'Georges', 'family': 'Kaltenbach', 'sequence': 'additional', 'affiliation': []}, {'given': 'Erik', 'family': 'Sauleau', 'sequence': 'additional', 'affiliation': []}], 'member': '1968', 'container-title': [], 'original-title': [], 'deposited': { 'date-parts': [[2020, 5, 4]], 'date-time': '2020-05-04T16:20:08Z', 'timestamp': 1588609208000}, 'score': 1, 'resource': {'primary': {'URL': ''}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2020, 5, 2]]}, 'references-count': 0, 'URL': '', 'relation': {}, 'published': {'date-parts': [[2020, 5, 2]]}, 'subtype': 'preprint'}
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