Severe clinical outcomes of COVID-19 associated with proton pump inhibitors: a nationwide cohort study with propensity score matching

{ 'indexed': {'date-parts': [[2024, 7, 19]], 'date-time': '2024-07-19T14:27:08Z', 'timestamp': 1721399228595}, 'reference-count': 36, 'publisher': 'BMJ', 'issue': '1', 'license': [ { 'start': { 'date-parts': [[2020, 7, 30]], 'date-time': '2020-07-30T00:00:00Z', 'timestamp': 1596067200000}, 'content-version': 'tdm', 'delay-in-days': 0, 'URL': 'https://bmj.com/coronavirus/usage'}], 'funder': [ { 'DOI': '10.13039/501100003725', 'name': 'National Research Foundation of Korea', 'doi-asserted-by': 'crossref', 'award': ['NRF2019R1G1A109977912']}], 'content-domain': {'domain': ['bmj.com'], 'crossmark-restriction': True}, 'published-print': {'date-parts': [[2021, 1]]}, 'abstract': '<jats:sec><jats:title>Objective</jats:title><jats:p>The adverse effects of proton pump ' 'inhibitors (PPIs) have been documented for pneumonia; however, there is no consensus ' 'regarding whether the use of PPIs might be harmful regarding the risk of severe acute ' 'respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In this regard, we aimed to ' 'measure the potential associations of the current use of PPIs with the infection rates of ' 'COVID-19 among patients who underwent SARS-CoV-2 ' 'testing.</jats:p></jats:sec><jats:sec><jats:title>Design</jats:title><jats:p>Data were ' 'derived from a Korean nationwide cohort study with propensity score matching. We included 132 ' '316 patients older than 18 years who tested for SARS-CoV-2 between 1 January and 15 May 2020. ' 'Endpoints were SARS-CoV-2 positivity (primary) and severe clinical outcomes of COVID-19 ' '(secondary: admission to intensive care unit, administration of invasive ventilation or ' 'death).</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>In the entire ' 'cohort, there were 111 911 non-users, 14 163 current PPI users and 6242 past PPI users. After ' 'propensity score matching, the SARS-CoV-2 test positivity rate was not associated with the ' 'current or past use of PPIs. Among patients with confirmed COVID-19, the current use of PPIs ' 'conferred a 79% greater risk of severe clinical outcomes of COVID-19, while the relationship ' 'with the past use of PPIs remained insignificant. Current PPI use starting within the ' 'previous 30 days was associated with a 90% increased risk of severe clinical outcomes of ' 'COVID-19.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Patients ' 'taking PPIs are at increased risk for severe clinical outcomes of COVID-19 but not ' 'susceptible to SARS-CoV-2 infection. This suggests that physicians need to assess ' 'benefit–risk assessments in the management of acid-related diseases amid the COVID-19 ' 'pandemic.</jats:p></jats:sec>', 'DOI': '10.1136/gutjnl-2020-322248', 'type': 'journal-article', 'created': {'date-parts': [[2020, 7, 30]], 'date-time': '2020-07-30T21:33:51Z', 'timestamp': 1596144831000}, 'page': '76-84', 'update-policy': 'http://dx.doi.org/10.1136/crossmarkpolicy', 'source': 'Crossref', 'is-referenced-by-count': 163, 'title': 'Severe clinical outcomes of COVID-19 associated with proton pump inhibitors: a nationwide cohort ' 'study with propensity score matching', 'prefix': '10.1136', 'volume': '70', 'author': [ {'given': 'Seung Won', 'family': 'Lee', 'sequence': 'first', 'affiliation': []}, {'given': 'Eun Kyo', 'family': 'Ha', 'sequence': 'additional', 'affiliation': []}, {'given': 'Abdullah Özgür', 'family': 'Yeniova', 'sequence': 'additional', 'affiliation': []}, {'given': 'Sung Yong', 'family': 'Moon', 'sequence': 'additional', 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