Pre-hospital proton pump inhibitor use and clinical outcomes in hospitalized COVID-19 patients: A retrospective case-control study
Abstract
Background: Proton pump inhibitors (PPIs) are among the most commonly prescribed medications globally. While concerns exist regarding their association with adverse infection-related outcomes, their impact on coronavirus disease 2019 (COVID-19) severity remains uncertain. Emerging preclinical data suggest immunomodulatory and antiviral properties of PPIs, yet clinical evidence is conflicting.
Aim: To investigate whether chronic pre-hospital PPI use is associated with improved outcomes in patients hospitalized with COVID-19.
Methods: We conducted a retrospective case-control study of adult inpatients with severe acute respiratory syndrome coronavirus 2 infection admitted to a racially and ethnically diverse community hospital in Massachusetts from July 2021 to March 2022. Patients were stratified by documented pre-hospital PPI use. The primary outcomes were intensive care unit (ICU) admission, need for invasive mechanical ventilation, and in-hospital mortality. Multivariable logistic regression was used to adjust for demographics, comorbidities, and treatment variables. Significance was set at P < 0.05.
Results: Among 248 patients, 83 (33.4%) were on PPIs prior to hospitalization. Compared to non-users, PPI users had significantly lower rates of ICU admission (13.3% vs 24.8%, P = 0.034), mechanical ventilation (13.3% vs 25.5%, P = 0.027), and in-hospital mortality (6.0% vs 17.6%, P = 0.013). Multivariable analysis confirmed these associations: ICU admission [adjusted odds…
How strong is the evidence?
Evidence Hub reads this as a case-control, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 248 participants or records.
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