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Risk for COVID-19 Increased for Adults Taking PPIs

Dose-response relationship observed; risk up 3.67-fold for those using PPIs up to twice daily

FRIDAY, July 10, 2020 (HealthDay News) — Adults taking proton pump inhibitors (PPIs) have an increased risk for having a positive COVID-19 test, with evidence of a dose-response relationship, according to a study published online July 7 in preprint format in the American Journal of Gastroenterology.

Christopher V. Almario, M.D., from Cedars-Sinai Medical Center in Los Angeles, and colleagues examined whether use of PPIs increases the odds of acquiring COVID-19 among community-dwelling Americans who were surveyed from May 3 to June 24, 2020.

The researchers found that 6.4 percent of the 53,130 participants reported a positive COVID-19 test. Compared with those not taking PPIs, individuals using PPIs up to once daily or twice daily had significantly increased odds for reporting a positive COVID-19 test (odds ratios, 2.15 and 3.67, respectively). Risk was not elevated for individuals taking histamine-2 receptor antagonists.

“The highest risk is seen among individuals taking PPIs twice daily — a common practice in both primary and secondary care — as they are nearly four-times more likely to report COVID-19 positivity when compared to those not on PPIs,” the authors write. “Since meta-analysis reveals that twice daily PPIs do not offer clinically meaningful benefits over once daily dosing for gastroesophageal reflux disease, our findings further emphasize that PPIs should only be used when clinically indicated at the lowest effective dose.”

Several authors disclosed financial ties to the pharmaceutical and health care industries.

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