Use of proton pump inhibitors are associated with higher mortality in hospitalized patients with COVID-19
Shengyong Wu, Zhichao Jin, Chi Peng, Dongdong Li, Yi Cheng, Ronghui Zhu, Professor Jia He, Professor Cheng Wu
Journal of Global Health, doi:10.7189/jogh.12.05005
Background The adverse effects of proton pump inhibitors (PPIs) on pneumonia have been well reported. However, the relationship between the use of PPIs and the adverse outcomes of coronavirus disease 2019 (COVID-19) is currently inconclusive. In this study, we aimed to explore the relationship between the use of PPIs and the in-hospital mortality among patients who were laboratory-confirmed SARS-CoV-2. Methods Data was derived from 2 hospitals which both were the first batch of SARS-CoV-2 specialist hospitals with four types of sensitivity analyses. This cohort included 4634 patients older than 18 years who were laboratory-confirmed SARS-CoV-2. Endpoints were death in hospital (primary) and the recovery of COVID-19 (secondary: the time of COVID-19 nucleic acid testing turning negative).
Results In the entire cohort, there were 3588 non-users, 399 ≤ 0.5 defined daily dose (DDD) PPIs users, 483 1 DDD users, and 164 ≥ 1.5 DDD users. The multivariate logistic regression analysis (odds ratio (OR) = 3.63, 95% confidence interval (CI) = 1.83-7.23, P = 0.0002) and four types of sensitivity analyses showed higher mortality in patients using PPIs during hospitalization, while the relationship between different PPIs dosages and the hospital mortality remained insignificant. Usage of the PPIs significantly prolongs the time of COVID-19 nucleic acid testing turning negative.
Conclusions The use of PPIs may increase the risk of in-hospital death of patients who were laboratory-confirmed SARS-CoV-2, which means that physicians may need to re-evaluate the benefit-risk assessment of the use of PPIs during the COVID-19 pandemic.
Authorship contributions: JH, CW and SW designed research, developed the analysis plan, and obtained the funding. ZJ and CP collated and curated all data. SW analyzed the data. All authors contributed to collect relevant literature and revise the manuscript. All authors were involved in the finalization of the manuscript and all approved the final version for submission for publication. SW, and ZJ authors contributed equally to the study. All authors read and approved the final manuscript.
Competing interests: The authors have completed the ICMJE Declaration of Interest form (available upon request from the corresponding authors) and declare they have no competing interests.
Additional material Online Supplementary Document
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'article-title': 'COVID-19 in patients with HIV: clinical case series.',
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'journal-title': 'Lancet HIV'}],
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'date-time': '2023-01-27T04:15:40Z',
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'resource': {'primary': {'URL': 'http://jogh.org/documents/2022/jogh-12-05005.pdf'}},
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'URL': 'http://dx.doi.org/10.7189/jogh.12.05005',
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'container-title-short': 'J Glob Health',
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