Abstract: Jpn. J. Infect. Dis., 75, 10-15, 2022
Original Article
Does Proton Pump Inhibitor Use Lead to a Higher Risk of Coronavirus Disease
2019 Infection and Progression to Severe Disease? a Meta-analysis
Cunye Yan1†, Yue Chen2†, Chenyu Sun3*, Mubashir Ayaz Ahmed3, Chandur Bhan3, Zhichun Guo4,
Hongru Yang4, Yijing Zuo4, Yue Yan4, Lei Hu2, Yiceng Sun1, Yao Li1, and Qin Zhou5
1
Department of Breast and Thyroid Surgery, Chongqing General Hospital, University of Chinese Academy of
Sciences, Chongqing; 2Department of Clinical Medicine, School of the First Clinical Medicine, Anhui Medical
University, Anhui, P.R. China; 3AMITA Health Saint Joseph Hospital Chicago, Chicago, IL;
4
Massachusetts College of Pharmacy and Health Sciences, Boston, MA; and
5
Radiation Oncology, Mayo Clinic, Rochester, MN, USA
ABSTRACT: The findings of previous research on the association between proton pump inhibitor
(PPI) use and the treatment and prevention of coronavirus disease 2019 (COVID-19) are inconsistent.
Therefore, this meta-analysis was conducted to clarify the outcomes of patients taking PPIs. This
analysis included 14 articles with more than 268,683 subjects. PPI use was not associated with
increased or decreased risk of COVID-19 infection (odds ratio [OR] 1.64, 95% confidence interval
[CI] = 0.54–5.00, P = 0.39) or mortality (OR = 1.91, 95% CI = 0.86–4.24, P = 0.11). However, PPI
use increased the risks of severe disease (OR 1.67, 95% CI = 1.37–2.02, P < 0.00001) and secondary
infection (OR 4.62, 95% CI = 2.55–8.39, P < 0.00001). In summary, PPI use was not associated
with an increased risk of infection and mortality in COVID-19 but appeared to be associated with an
increased risk of progression to severe disease and secondary infection. However, more original studies
are urgently needed to further clarify the relationship between PPI use and COVID-19.
which is widely expressed in the gastrointestinal tract
(4). Nearly half of patients with COVID-19 have
viral RNA in their feces (5). These results suggest a
strong correlation between the gastrointestinal system
and SARS-CoV-2 infection. Therefore, it is of great
importance to study the relationship between the most
commonly used drugs for acid suppression, proton
pump inhibitors (PPIs), and COVID-19 infection.
While PPIs have been postulated to be beneficial in
COVID-19 treatment and prevention (6), other studies
have suggested that PPI could potentially aggravate
the condition of patients with COVID-19, leading to
increased mortality (7). Owing to these controversial
conclusions, we conducted this meta-analysis to
further explore the relationship between PPI use and
COVID-19, with more detailed subgroup analyses of
different outcome indexes.
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'title': 'Does Proton Pump Inhibitor Use Lead to a Higher Risk of Coronavirus Disease 2019 Infection and '
'Progression to Severe Disease? a Meta-analysis',
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