Effect of Preadmission Proton Pump Inhibitor (PPI) on the clinical outcome of Covid-19 Hospitalised Patients during the Pandemic

COVID-19 has proved to be a severe disease since the end of 2019; according to WHO, over 600 million people have contracted this infection [1] . Most people who contracted this disease showed no symptoms. Initially, the mean hospitalisation period for symptomatic patients was 16 days, ranging between 3 to 45 days [2] . A significant complication of COVID-19 was found to be respiratory hypoxaemia, which accounted for up to 75% of hospital admissions secondary to pneumonia, along with acute respiratory disease (ARDS). While prodromal systems, such as fever, cough and shortness of breath, were seen in most symptomatic Covid patients, many system involvements were also observed. For instance, 19.7% of patients were found to have a cardiac injury [3] . Similarly, many systems involvements have been observed in SARS patients: 36.4% showed neurological manifestations of their disease [4], 19% had Abstract Methodology: Prospectively captured observational data was analyzed to include patients (>18 yr.) at the hospital with COVID-19 infection. PPI data was derived from hospital and primary care records, and the study period is between February 2020 and February 2021. Clinical outcomes of COVID-19 patients who were on proton pump inhibitors preadmission were compared with those of COVID-19 patients who were not on proton pump inhibitors simultaneously. The study's primary endpoint was 60-day mortality, intensive care unit admission, high dependency unit admission, and the development of COVID-19 complications. Additional endpoints included the length of critical care admission. Study type: Observational Cohort Study. Results: 309 patients were evaluated in this study; 159 were on proton pump inhibitors, and 150 were not on proton pump inhibitors at index admission. The mean length of stay was 9.8 in the PPI group and 12.1 in the non-PPI group. A slightly increased mortality rate of 22.6% in the PPI group compared with 19.3 % in the non-PPI group. Intensive Care Unit (ITU) and High Dependency Unit (HDU) admissions were higher in the PPI group (56.6%,30.8% respectively) than in the non-PPI group (45.3%,20.7%). Complications were more common in the PPI group74.8% had pulmonary complications, and 3.1% had thromboembolic complications. In the non-PPI group, 54% had pulmonary complications, which was over 20 % less than in the PPI group, 6% had thromboembolic complications, 1.93 times more than the PPI group. Conclusion: In Our study, PPI usage at index admission succeeded in showing worsening of outcomes in Covid 19 hospitalised patients, similar to recently published papers. This proposed causation needs further evaluation via well-conducted prospective studies.