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Proton Pump Inhibitor Use Is Not Strongly Associated With SARS-CoV-2 Related Outcomes: A Nationwide Study and Meta-analysis

Israelsen et al., Clinical Gastroenterology and Hepatology, doi:10.1016/j.cgh.2021.05.011, EUPAS35835
Sep 2021  
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Mortality, all patients 5% Improvement Relative Risk Mortality, within cases 12% Ventilation, all patients -8% Ventilation, within cases 0% ICU admission, all patients -5% ICU admission, within c.. 3% Hospitalization, all patients -22% Hospitalization, within c.. -13% Case -8% Proton Pump Inhibitors  Israelsen et al.  Prophylaxis Is prophylaxis with proton pump inhibitors beneficial for COVID-19? Retrospective 322,975 patients in Denmark (February - December 2020) Higher hospitalization (p=0.005) and more cases (p=0.0012) c19early.org Israelsen et al., Clinical Gastroenter.., Sep 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 = 0.000000048 from 40 studies.
5,300+ studies for 115 treatments. c19early.org
Retrospective 83,224 SARS-CoV-2 cases and 332,799 controls in Denmark showing increased risk of infection and hospital admission with proton pump inhibitor (PPI) use, but no significant association with ICU admission or mortality.
risk of death, 5.0% lower, RR 0.95, p = 0.70, treatment 166 of 3,955 (4.2%), control 189 of 3,955 (4.8%), NNT 172, adjusted per study, all patients, propensity score matching, multivariable.
risk of death, 12.0% lower, RR 0.88, p = 0.22, treatment 166 of 3,955 (4.2%), control 189 of 3,955 (4.8%), NNT 172, adjusted per study, within cases, propensity score matching, multivariable.
risk of mechanical ventilation, 8.0% higher, RR 1.08, p = 0.73, treatment 55 of 3,955 (1.4%), control 55 of 3,955 (1.4%), adjusted per study, all patients, propensity score matching, multivariable.
risk of mechanical ventilation, no change, RR 1.00, p = 1.00, treatment 55 of 3,955 (1.4%), control 55 of 3,955 (1.4%), adjusted per study, within cases, propensity score matching, multivariable.
risk of ICU admission, 4.8% higher, RR 1.05, p = 0.80, treatment 92 of 3,955 (2.3%), control 95 of 3,955 (2.4%), NNT 1318, adjusted per study, all patients, propensity score matching, multivariable.
risk of ICU admission, 3.0% lower, RR 0.97, p = 0.84, treatment 92 of 3,955 (2.3%), control 95 of 3,955 (2.4%), NNT 1318, adjusted per study, within cases, propensity score matching, multivariable.
risk of hospitalization, 22.0% higher, RR 1.22, p = 0.005, treatment 734 of 3,955 (18.6%), control 650 of 3,955 (16.4%), adjusted per study, all patients, propensity score matching, multivariable.
risk of hospitalization, 13.0% higher, RR 1.13, p = 0.010, treatment 734 of 3,955 (18.6%), control 650 of 3,955 (16.4%), adjusted per study, within cases, propensity score matching, multivariable.
risk of case, 8.0% higher, OR 1.08, p = 0.001, treatment 4,473 of 63,886 (7.0%) cases, 17,553 of 259,089 (6.8%) controls, adjusted per study, case control OR, current vs. non-use, multivariable.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Israelsen et al., 30 Sep 2021, retrospective, Denmark, peer-reviewed, 7 authors, study period 27 February, 2020 - 1 December, 2020, trial EUPAS35835.
This PaperPPIsAll
Proton Pump Inhibitor Use Is Not Strongly Associated With SARS-CoV-2 Related Outcomes: A Nationwide Study and Meta-analysis
Simone Bastrup Israelsen, Martin Thomsen Ernst, Andreas Lundh, Lene Fogt Lundbo, Håkon Sandholdt, Jesper Hallas, Thomas Benfield
Clinical Gastroenterology and Hepatology, doi:10.1016/j.cgh.2021.05.011
PPI use does not impact SARS-CoV-2 related outcomes No difference -Risk of infection -Severe outcomes
Supplementary Material Note: To access the supplementary material accompanying this article, visit the online version of Clinical Gastroenterology and Hepatology at www.cghjournal.org, and at https://doi.org/10.1016/j.cgh.2021.05.011. Conflicts of interest This author discloses the following: Thomas Benfield reports grants from Novo Nordisk Foundation, grants from Simonsen Foundation, grants and personal fees from GSK, grants and personal fees from Pfizer, personal fees from Boehringer Ingelheim, grants and personal fees from Gilead, personal fees from MSD, grants from Lundbeck Foundation, grants from Kai Hansen Foundation, and personal fees from Pentabase A/S, with no relation to the work reported in this article. The remaining authors disclose no conflicts. Adjusted for age, sex, comorbidities (peptic ulcer, asthma, chronic obstructive pulmonary disease, cirrhosis, ischemic heart disease, diabetes, renal failure, heart failure, stroke, alcohol-related diagnoses, smoking-related diagnoses, major psychiatric disorders), other current medication use (systemic and inhaled corticosteroids, bronchodilators, H2-receptor antagonists, nonsteroidal anti-inflammatory drugs, anticholinergic agents, immunosuppressants, antipsychotic agents, antibiotics, alcohol abstinence treatment, smoking cessation treatment, blood pressure lowering drugs, lipid lowering drugs, glucose lowering drugs, antiplatelets, anticoagulants), Charlson Comorbidity Index (0, 1-2, 3þ), and number of hospital..
References
Almario, Chey, Spiegel, Increased risk of COVID-19 among users of proton pump inhibitors, Am J Gastroenterol
Benfield, None, Conceptualization: Equal; Funding acquisition: Equal; Investigation: Equal; Methodology: Equal; Supervision: Lead; Writingreview & editing: Equal) Crude Death
Blanc, Waechter, Vogel, Interest of proton pump inhibitors in reducing the occurrence of COVID-19: a casecontrol study, Preprints
Darnell, Subbarao, Feinstone, Inactivation of the coronavirus that induces severe acute respiratory syndrome, SARS-CoV, J Virol Methods
Elmunzer, Spitzer, Foster, Digestive manifestations in patients hospitalized with COVID-19, Clin Gastroenterol Hepatol
Fan, Liu, Miyata, Effect of acid suppressants on the risk of COVID-19: a propensity score-matched study using UK Biobank, Gastroenterology
Forgacs, Loganayagam, Overprescribing proton pump inhibitors
Gulmez, Holm, Frederiksen, Use of proton pump inhibitors and the risk of community-acquired pneumonia: a population-based case-control study, Arch Intern Med
Herzig, Howell, Ngo, Acid-suppressive medication use and the risk for hospital-acquired pneumonia, JAMA
Huh, Kang, Association of previous medications with the risk of COVID-19: a nationwide claims-based study from South Korea, medRxiv
Kamal, Khan, Sharma, Lack of consistent associations between pharmacologic gastric acid suppression and adverse outcomes in patients with coronavirus disease 2019: meta-analysis of observational studies, Gastroenterology
Kow, Hasan, Use of proton pump inhibitors and risk of adverse clinical outcomes from COVID-19: a meta-analysis, J Intern Med
Lambert, Lam, Paik, Risk of community-acquired pneumonia with outpatient proton-pump inhibitor therapy: a systematic review and meta-analysis, PLoS One
Lee, Ha, Yeniova, Severe clinical outcomes of COVID-19 associated with proton pump inhibitors: a nationwide cohort study with propensity score matching, Gut
Li, Yu, Do proton pump inhibitors influence SARS-CoV-2 related outcomes? a meta-analysis, Gut
Luxenburger, Sturm, Biever, Treatment with proton pump inhibitors increases the risk of secondary infections and ARDS in hospitalized patients with COVID-19: coincidence or underestimated risk factor?, J Intern Med
Pottegård, Kristensen, Reilev, Existing data sources in clinical epidemiology: the Danish COVID-19 cohort, Clin Epidemiol
Ramachandran, Perisetti, Gajendran, Pre-hospitalization proton pump inhibitor use and clinical outcomes in COVID-19, Eur J Gastroenterol Hepatol
Tarlow, Gubatan, Khan, Are proton pump inhibitors contributing to SARS-COV-2 infection?, Am J Gastroenterol
Thomsen, Formal analysis: Lead; Investigation: Equal; Methodology: Equal; Writingreview & editing: Supporting) Andreas Lundh (Formal analysis: Supporting; Investigation: Equal; Methodology: Equal; Writingreview & editing: Equal) Lene Fogt Lundbo (Conceptualization: Equal; Investigation: Equal; Methodology: Equal; Writingreview & editing: Equal) Håkon Sandholdt (Formal analysis: Supporting; Investigation: Equal; Methodology: Equal; Writingreview & editing: Supporting) Jesper Hallas (Investigation: Equal; Methodology: Equal; Supervision: Supporting; Writingreview & editing: Equal
Toubasi, Abuanzeh, Khraisat, A meta-analysis: proton pump inhibitors current use and the risk of coronavirus infectious disease 2019 development and its related mortality, Arch Med Res
Ullah, Kocher, Chelala, COVID-19 in patients with hepatobiliary and pancreatic diseases in East London: a singlecentre cohort study, Pancreatology
Vila-Corcoles, Satue-Gracia, Ochoa-Gondar, Use of distinct anti-hypertensive drugs and risk for COVID-19 among hypertensive people: a population-based cohort study in Southern Catalonia, Spain, J Clin Hypertens
Wiersinga, Rhodes, Cheng, Pathophysiology, transmission, diagnosis, and treatment of coronavirus disease 2019 (COVID-19): a review, JAMA
Xiang, Wong, Hon-Cheong, Exploring drugs and vaccines associated with altered risks and severity of COVID-19: a UK Biobank cohort study of all ATC level-4 drug categories, medRxiv
Xiao, Tang, Zheng, Evidence for gastrointestinal infection of SARS-CoV-2, Gastroenterology
Zhou, Wang, Lee, Proton pump inhibitor or famotidine use and severe COVID-19 disease: a propensity scorematched territory-wide study, Gut
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