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Proton Pump Inhibitors: Current Use and the Risk of Coronavirus Infectious Disease 2019 Development and its Related Mortality. Meta-analysis

Toubasi et al., Archives of Medical Research, doi:10.1016/j.arcmed.2021.03.004
Aug 2021  
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Mortality -67% Improvement Relative Risk Case -19% PPIs for COVID-19  Toubasi et al.  META ANALYSIS c19early.org FavorsPPI 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 109 treatments. c19early.org
Meta-analysis of 6 studies with 195,230 participants showing significantly higher COVID-19 mortality with PPI use.
8 meta analyses show significant harm with PPIs for mortality1-3, severity1,2,4-8, and cases2.
Currently there are 39 PPIs for COVID-19 studies, showing 40% higher mortality [17‑67%], 14% higher ventilation [-1‑32%], 15% higher ICU admission [1‑30%], 9% higher hospitalization [3‑16%], and 2% fewer cases [-6‑10%].
risk of death, 67.0% higher, OR 1.67, p < 0.001, RR approximated with OR.
risk of case, 19.0% higher, OR 1.19, p = 0.61, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Toubasi et al., 31 Aug 2021, peer-reviewed, 5 authors. Contact: ban0175810@ju.edu.jo.
This PaperPPIsAll
Proton Pump Inhibitors: Current Use and the Risk of Coronavirus Infectious Disease 2019 Development and its Related Mortality. Meta-analysis
Ahmad Amjed Toubasi, Rand Bilal Abuanzeh, Bann Rami Khraisat, Thuraya Nael Al-Sayegh, Saif Aldeen Alryalat
Archives of Medical Research, doi:10.1016/j.arcmed.2021.03.004
Background. The ongoing Coronavirus Infectious Disease (COVID-19) pandemic is a global health crisis that has had a magnanimous worldwide impact on all aspects of people's lives. Several observational studies investigated the relationship between Proton Pump Inhibitors use and the risk of COVID-19 development and mortality. Aim of the Study. The aim of this meta-analysis is to investigate the association between current PPIs use and the development of COVID-19 as well as its mortality. Methods. Pubmed, Google Scholar, ScienceDirect and medRxiv were searched until November 21, 2020 using the following keywords: proton pump inhibitors and COVID-19 as well as their related MESH terms. The studies considered in the meta-analysis were either cohort or case-control in design and adjusted for confounding factors. The quality of the studies included in this meta-analysis was assessed using the Newcastle-Ottawa Scale. In addition, a random-effects model was used to calculate the pooled Odds Ratio (ORs) and the corresponding confidence interval (95% CI). Heterogeneity was evaluated using The Cochran's Q heterogeneity test and I 2 statistic. Results. Six observational studies with 195,230 participants were included. In this metaanalysis, current use of PPIs increased risk of COVID-19 development (OR = 1.19; 95% CI: 0.62-2.28) and mortality (OR = 1.67; 95% CI: 1.41-1.97). Conclusions. Our meta-analysis indicates that current PPIs use significantly increased the risk of COVID-19 mortality, but it did not reach a significant threshold in regards to the risk of COVID-19 development.
Conflicts of Interest The Author(s) declare(s) that there is no conflict of interest.
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