An independent, dose-response relationship was seen between proton pump inhibitor use and COVID-19 positivity, according to a study published in the American Journal of Gastroenterology.
This study was an online population-based survey of 53,130 English-speaking adult Americans. Respondents were asked about any current PPI and/or histamine-2 receptor antagonist (H2RA) use and were also asked about whether they have tested positive for COVID-19. The authors then performed a regression analysis to test the relationship between anti secretory use and risk of COVID-19 while adjusting for a wide range of potential confounders, including demographic, socioeconomic, lifestyle, and comorbidity variables.
The authors found that PPI use was independently associated with increased odds for COVID-19. Moreover, there was a dose-response relationship between the amount of acid suppression and the risk of COVID-19 that fell along a biological gradient. Compared to those not using PPIs, those taking twice-daily PPIs registered a 3.7-fold increased odds of COVID-19, whereas those using PPIs up to once daily had a 2.2-fold increase.
In contrast, people taking less powerful H2RAs were not at increased risk for COVID-19. Of note, the risk of PPIs remained significant regardless of duration of use, including those who had been on PPIs for six months or greater, before the start of the pandemic. In addition to PPI usage, males, current smokers, non-Hispanic blacks, and Latinxs were significantly more likely to report being positive for COVID-19, consistent with previous research.
Source: American Journal of Gastroenterology