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All Studies   Meta Analysis       

Effect of Acid Suppressants on the Risk of COVID-19: A Propensity Score-Matched Study Using UK Biobank

Fan et al., Gastroenterology, doi:10.1053/j.gastro.2020.09.028
Jan 2021  
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Mortality, all UGI -17% Improvement Relative Risk Mortality, positive UGI 4% Mortality, all 14% Mortality, all positive 20% Case, UGI -22% Case, all -8% Proton Pump Inhibitors  Fan et al.  Prophylaxis Is prophylaxis with proton pump inhibitors beneficial for COVID-19? PSM retrospective study in the United Kingdom (Mar - Jun 2020) More cases with proton pump inhibitors (not stat. sig., p=0.15) c19early.org Fan et al., Gastroenterology, January 2021 FavorsPPIs Favorscontrol 0 0.5 1 1.5 2+
PPIs for COVID-19
1st treatment shown to increase risk in September 2020, now with p = 0.00000012 from 39 studies.
5,100+ studies for 112 treatments. c19early.org
PSM retrospective 9,469 UK Biobank participants tested for COVID-19, showing no significant association between proton pump inhibitor (PPI) or histamine-2 receptor antagonist (H2RA) use and risk of SARS-CoV-2 infection or COVID-19 mortality. Omeprazole was associated with higher risk of cases in patients with upper gastrointestinal diseases. The results for patients with upper gastrointestinal diseases should be more accurate due to reduced confounding and more accurate ascertainment of current use.
risk of death, 17.1% higher, RR 1.17, p = 0.69, all upper gastrointestinal disease patients, propensity score matching.
risk of death, 4.0% lower, HR 0.96, p = 0.88, positive upper gastrointestinal disease patients only, propensity score matching.
risk of death, 13.6% lower, HR 0.86, p = 0.59, all patients, propensity score matching.
risk of death, 20.0% lower, HR 0.80, p = 0.18, all positive patients, propensity score matching.
risk of case, 22.0% higher, OR 1.22, p = 0.15, upper gastrointestinal disease patients, propensity score matching, RR approximated with OR.
risk of case, 8.0% higher, OR 1.08, p = 0.44, all patients, propensity score matching, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Fan et al., 31 Jan 2021, retrospective, United Kingdom, peer-reviewed, 8 authors, study period 16 March, 2020 - 29 June, 2020.
This PaperPPIsAll
Effect of Acid Suppressants on the Risk of COVID-19: A Propensity Score-Matched Study Using UK Biobank
Xiude Fan, Zhengwen Liu, Tatsunori Miyata, Srinivasan Dasarathy, Daniel M Rotroff, Xiaoqin Wu, Kyle L Poulsen, PhD Laura E Nagy
Gastroenterology, doi:10.1053/j.gastro.2020.09.028
C oronavirus disease 2019 (COVID-19) is a highly contagious and life-threatening infection caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). 1 Identifying modifiable risk factors for COVID-19 would be of substantial public health benefit. To date, several studies exploring the association between use of acid suppressants and COVID-19 have produced conflicting results, 2-6 which makes it difficult to determine whether there is indeed an increased risk of SARS-CoV-2 infection and death for users of acid suppressants. Thus, we aimed to clarify the potential impact of acidsuppressant treatment on the risk of SARS-CoV-2 infection and death in patients with COVID-19.
Supplementary Material Note: To access the supplementary material accompanying this article, visit the online version of Gastroenterology at www.gastrojournal.org, and at https://doi.org/10. 1053
References
Almario, None, Am J Gastroenterol, doi:10.14309/ajg.0000000000000798
Benjamini, None, J R Stat Soc Series B Stat Methodol
Bergmann, None, Cleve Clin J Med
Freedberg, None, Gastroenterology, doi:10.1053/j.gastro.2020.05.053
Luxenburger, None, J Intern Med, doi:10.1111/joim.13121
Sudlow, None, PLoS Med
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