The role of Proton Pump Inhibitors in COVID-19

Abstract

The use of proton pump inhibitors (PPIs) has been associated with an increased risk of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection and severe outcomes. This may be because the gut is the most important immune organ in the body and the virus reach and replicate rapidly in the absence of gastric acid. Therefore, the use of PPIs as acid suppressant drugs may have a negative impact on COVID-19. We aimed to identify the relationship between the use of PPIs with the incidence of Covid-19 and the severity of outcomes. This case-control study was conducted on 246 participants who were pretested for Covid-19 in Herat city, Afghanistan. We investigated the incidence rate and risk of severe clinical symptoms and outcomes (mechanical ventilation, intensive care unit (ICU) admission, and requirement of oxygen therapy) in COVID-19 patients. The incidence of Covid-19 was insignificantly higher among PPI users than non-users (OR 1.29, 95% CI 0.74 – 2.25). Moreover, the symptoms including respiratory, digestive and systemic complains, taste and smell disturbances and outcome of the disease were more severe in PPI users {OR (95% CI)}, 2.47 (0.71 – 8.63), 2.16 (0.97 – 4.84), 2.32 (1.01 – 5.31), 2.23 (1.05 – 4.72), 2.62 (1.23 – 5.45), 4.38 (2.01 – 9.51), 7.56 (2.93 – 19.61) and 5.99 (2.52 – 14.30) respectively. In Conclusion, we found a significantly increased risk of COVID-19 negative outcomes in PPIs users. Further studies with a larger sample size are needed to find the exact role of PPIs use on COVID-19.