Zhou et al. Famotidine for COVID-19 LATE TREATMENT
Is late treatment with famotidine beneficial for COVID-19?
PSM retrospective 3,114 patients in China (January - August 2020)
Higher severe cases with famotidine (p=0.0001)
Zhou et al., Gut, doi:10.1136/gutjnl-2020-323668
Proton pump inhibitor or famotidine use and severe COVID-19 disease: a propensity score-matched territory-wide study
Zhou et al.
Proton pump inhibitor or famotidine use and severe COVID-19 disease: a propensity score-matched territory-wide..
Retrospective 4,445 COVID+ patients in China, showing higher risk of combined death/intubation/ICU with famotidine treatment.
risk of severe case, , treatment 72 of 519 (13.9%), control 198 of 2,595 (7.6%), death/intubation/ICU, propensity score matching, Cox proportional hazards.
81.0% higher, HR 1.81, p < 0.001
Effect extraction follows
pre-specified rules prioritizing more serious outcomes. Submit updates
Zhou et al., 4 Dec 2020, retrospective, propensity score matching, China, peer-reviewed, 7 authors, study period 1 January, 2020 - 22 August, 2020.
Provenance and peer review Not commissioned;
externally peer reviewed.
To cite Derkinderen P, Noble W, Neunlist M, et al. Gut
Received 26 October 2020
Revised 29 October 2020
Accepted 3 November 2020
Published Online First 17 November 2020
Gut 2021;70:2010–2012. doi:10.1136/
Pascal Derkinderen http://o rcid.org/0000-0001-8792-
1 Lee H-S, Lobbestael E, Vermeire S, et al. Inflammatory
bowel disease and Parkinson’s disease: common
pathophysiological links. Gut 2021;70:408–17.
2 De Guilhem De Lataillade A, Lebouvier T, Noble W, et al.
Enteric synucleinopathy: real entity or only a trendy
concept? Free Neuropathology 2020;26:Seiten.
3 Prigent A, Lionnet A, Durieu E, et al. Enteric alpha-
synuclein expression is increased in Crohn’s disease.
Acta Neuropathol 2019;137:359–61.
4 Prigent A, Chapelet G, De Guilhem de Lataillade A,
et al. Tau accumulates in Crohn’s disease gut. Faseb J
5 Borghammer P, Van Den Berge N. Brain-First versus
Gut-First Parkinson’s disease: a hypothesis. J Parkinsons
6 Johnson ME, Stecher B, Labrie V, et al. Triggers,
facilitators, and Aggravators: redefining Parkinson’s
disease pathogenesis. Trends Neurosci 2019;42:4–13.
Figure 1 Kaplan-Meier curve stratified by
proton pump inhibitor (PPI) use before and
after propensity score matching.
Given these conflicting findings, we
conducted this territory-
wide study to
investigate whether PPI or famotidine use
was associated with a higher risk of severe
disease using propensity score matching.
The detailed methodology of the present
analyses is shown in the online supplemental appendix. A total of 4445 patients
(median age 44.8 years old, 95% CI: (28.9
to 60.8)); 50% male) were diagnosed
with the COVID-19 infection between
Proton pump inhibitor or
famotidine use and severe
COVID-19 disease: a propensity
We read the recent articles published in
Gut on the relationship between proton
pump inhibitor (PPI) use and outcomes
in COVID-19 with great interest.1 2 In
analysis, the authors found
that current or regular PPI users were
more likely to have severe outcomes
of COVID-19 than non-
users, but no
significant association was observed for
previous PPI use.2 The reason may be
reduced secretion of gastric acid that
can neutralise the SARS-
contrast, the use of famotidine, another
medication for gastric ulcers or gastro-
oesophageal reflux disease, was asso- Figure 2 Kaplan-Meier curve stratified by
ciated with better clinical outcomes in famotidine use before and after propensity
some studies,3 4 but not others.5 6
Gut October 2021 Vol 70 No 10
Gut: first published as 10.1136/gutjnl-2020-323668 on 4 December 2020.
© Author(s) (or their employer(s)) 2021. No commercial
re-use. See rights and permissions. Published by BMJ.
1 January 2020 and 22 August 2020 in
Hong Kong public hospitals or their associated ambulatory/outpatient facilities. On
follow-up until 8 September 2020, a total
of 212 patients (4.8%) met the primary
outcome of need for intensive care unit
(ICU) admission or intubation, or death
(online supplemental figure 1). The
median duration between hospitalisation
admission and ICU admission, intubation
or death were 35 (95% CI: 24.5 to 50.5),
33 (95% CI: 21.0 to 140.0)..
is less effective
Please send us corrections, updates, or comments. Vaccines and
treatments are complementary. All practical, effective, and safe means should
be used based on risk/benefit analysis. No treatment, vaccine, or intervention
is 100% available and effective for all current and future variants. We do not
provide medical advice. Before taking any medication, consult a qualified
physician who can provide personalized advice and details of risks and
benefits based on your medical history and situation.
provide treatment protocols.