Proton Pump Inhibitor Use Is Not Strongly Associated With SARS-CoV-2 Related Outcomes: A Nationwide Study and Meta-analysis
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Proton Pump Inhibitor Use Is Not Strongly Associated With SARS-CoV-2 Related Outcomes : A Nationwide Study and Meta-analysis. / Israelsen, Simone Bastrup; Ernst, Martin Thomsen; Lundh, Andreas; Lundbo, Lene Fogt; Sandholdt, Håkon; Hallas, Jesper; Benfield, Thomas.
In: Clinical Gastroenterology and Hepatology, Vol. 19, No. 9, 09.2021, p. 1845-1854.e6.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Proton Pump Inhibitor Use Is Not Strongly Associated With SARS-CoV-2 Related Outcomes
T2 - A Nationwide Study and Meta-analysis
AU - Israelsen, Simone Bastrup
AU - Ernst, Martin Thomsen
AU - Lundh, Andreas
AU - Lundbo, Lene Fogt
AU - Sandholdt, Håkon
AU - Hallas, Jesper
AU - Benfield, Thomas
N1 - Publisher Copyright: © 2021 The Authors
PY - 2021/9
Y1 - 2021/9
N2 - Background & Aims: Proton pump inhibitor (PPI) use has been associated with increased risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and severe outcomes. However, meta-analyses show unclear results, leading to uncertainty regarding the safety of PPI use during the ongoing coronavirus disease 2019 (COVID-19) pandemic. Methods: We conducted a nationwide observational study including all SARS-CoV-2 cases (n = 83,224) in Denmark as of December 1, 2020. The association of current PPI use with risk of infection was examined in a case-control design. We investigated the risk of severe outcomes, including mechanical ventilation, intensive care unit admission, or death, in current PPI users (n = 4473) compared with never users. Propensity score matching was applied to control for confounding. Finally, we performed an updated meta-analysis on risk of SARS-CoV-2 infection and COVID-19 mortality attributable to PPI use. Results: Current PPI use was associated with increased risk of infection; adjusted odds ratio, 1.08 (95% confidence interval [CI], 1.03–1.13). Among SARS-CoV-2 cases, PPI use was associated with increased risk of hospital admission; adjusted relative risk, 1.13 (1.03–1.24), but not with other severe outcomes. The updated meta-analysis showed no association between PPI use and risk of infection or mortality; pooled odds ratio, 1.00 (95% CI, 0.75–1.32) and relative risk, 1.33 (95% CI, 0.71–2.48). Conclusions: Current PPI use may be associated with an increased risk of SARS-CoV-2 infection and hospital admission, but these results with minimally elevated estimates are most likely subject to residual confounding. No association was found for severe outcomes. The results from the meta-analysis indicated no impact of current PPI use on COVID-19 outcomes.
AB - Background & Aims: Proton pump inhibitor (PPI) use has been associated with increased risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and severe outcomes. However, meta-analyses show unclear results, leading to uncertainty regarding the safety of PPI use during the ongoing coronavirus disease 2019 (COVID-19) pandemic. Methods: We conducted a nationwide observational study including all SARS-CoV-2 cases (n = 83,224) in Denmark as of December 1, 2020. The association of current PPI use with risk of infection was examined in a case-control design. We investigated the risk of severe outcomes, including mechanical ventilation, intensive care unit admission, or death, in current PPI users (n = 4473) compared with never users. Propensity score matching was applied to control for confounding. Finally, we performed an updated meta-analysis on risk of SARS-CoV-2 infection and COVID-19 mortality attributable to PPI use. Results: Current PPI use was associated with increased risk of infection; adjusted odds ratio, 1.08 (95% confidence interval [CI], 1.03–1.13). Among SARS-CoV-2 cases, PPI use was associated with increased risk of hospital admission; adjusted relative risk, 1.13 (1.03–1.24), but not with other severe outcomes. The updated meta-analysis showed no association between PPI use and risk of infection or mortality; pooled odds ratio, 1.00 (95% CI, 0.75–1.32) and relative risk, 1.33 (95% CI, 0.71–2.48). Conclusions: Current PPI use may be associated with an increased risk of SARS-CoV-2 infection and hospital admission, but these results with minimally elevated estimates are most likely subject to residual confounding. No association was found for severe outcomes. The results from the meta-analysis indicated no impact of current PPI use on COVID-19 outcomes.
KW - COVID-19
KW - Mortality
KW - PPI
KW - Risk of Infection
U2 - 10.1016/j.cgh.2021.05.011
DO - 10.1016/j.cgh.2021.05.011
M3 - Journal article
C2 - 33989790
AN - SCOPUS:85108812719
VL - 19
SP - 1845-1854.e6
JO - Clinical Gastroenterology and Hepatology
JF - Clinical Gastroenterology and Hepatology
SN - 1542-3565
IS - 9
ER -
ID: 285450093