Will Proton Pump Inhibitors Lead to a Higher Risk of COVID-19 Infection and Progression to Severe Disease? A Meta-analysis

  1. Cunye Yan
  2. Yue Chen
  3. Chenyu Sun
  4. Mubashir Ayaz Ahmed
  5. Chandur Bhan
  6. Ce Cheng
  7. Lei Hu
  8. Zhichun Guo
  9. Hongru Yang
  10. Chenyu Cao
  11. Ziwei Ji
  12. Yue Yan
  13. Yijing Zuo
  14. Yiceng Sun
  15. Yao Li
  16. Qin Zhou
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Abstract

Background

Previous researches on the association between proton pump inhibitors (PPIs) use and the treatment and prevention of COVID-19 have generated inconsistent findings. Therefore, this Meta-analysis was conducted to clarify the outcome in patients who take PPIs.

Methods

We carried out a systematic search to identify potential studies until November 2020. Heterogeneity was assessed using the I-squared statistic. Odds ratios (ORs) with its 95% confidence intervals (CIs) were calculated by fixed-effects or random-effects models according to the heterogeneity. Sensitivity analyses and tests for publication bias were also performed.

Results

Eight articles with more than 268,683 subjects were included. PPI use was not associated with increased or decreased risk of COVID-19 infection (OR:3.16, 95%CI = 0.74-13.43, P =0.12) or mortality risk of COVID-19 patients (OR=1.91, 95% CI=0.86-4.24, P =0.11). While it can add risk of severe disease (OR=1.54, 95% CI=1.20-1.99, P <0.001;) and secondary infection (OR=4.33, 95% CI=2.57-7.29). No publication bias was detected.

Conclusions

PPI use is not associated with increased risk infection and may not change the mortality risk of COVID-19, but appeared to be associated with increased risk of progression to severe disease and secondary infection. However, more original studies to further clarify the relationship between PPI and COVID-19 are still urgently needed.

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