Pre-hospitalization proton pump inhibitor use and clinical outcomes in COVID-19

Introduction Severe acute respiratory syndrome coronavirus-2 may escape the inactivation by gastric acid because of hypochlorhydria caused by proton pump inhibitors (PPIs), which could predispose the patients to severe COVID-19. Methods We studied the association between prehospitalization PPI exposure and clinical outcomes among hospitalized COVID-19 patients. Results A total of 295 hospitalized COVID-19 patients were included in the study. 15.6% of hospitalized COVID-19 patients were on PPIs at home. Mortality among PPI-users was 2.3 times higher than non-users, along with 2.3 times higher risk of acute respiratory distress syndrome after adjusting for confounding variables. Conclusion We found that prehospitalization PPI-exposure is independently associated with worse clinical outcomes, including mortality in COVID-19 patients, regardless of the presence of cardiovascular comorbidities.

Automated summary

Reduced gastric acid caused by proton pump inhibitors may predispose COVID-19 patients to severe infections and increase mortality risk.