tetano
Editor, Senior Moderator
Pharmacotherapy
. 2024 Oct 18.
doi: 10.1002/phar.4614. Online ahead of print. Use of proton pump inhibitors and risk of severe COVID-19: A case-control study in United States Medicare beneficiaries
Andrew D Mosholder[SUP] 1 [/SUP], Hector S Izurieta[SUP] 2 [/SUP], Rongmei Zhang[SUP] 1 [/SUP], Shanlai Shangguan[SUP] 3 [/SUP], Yun Lu[SUP] 2 [/SUP], Sandia Akhtar[SUP] 3 [/SUP], Michael Wernecke[SUP] 3 [/SUP], Jiwei He[SUP] 1 [/SUP], Yoganand Chillarige[SUP] 3 [/SUP], Yuhui Feng[SUP] 3 [/SUP], Armen Avagyan[SUP] 3 [/SUP], Kira Leishear[SUP] 1 [/SUP], Richard A Forshee[SUP] 2 [/SUP], Thomas E MaCurdy[SUP] 3 4 [/SUP], Jeffrey A Kelman[SUP] 5 [/SUP], David J Graham[SUP] 1 [/SUP]
Affiliations
Background: Concerns have been raised regarding proton pump inhibitor (PPI) use and risk of severe coronavirus disease 2019 (COVID-19). Observational studies have yielded heterogeneous results and were subject to important methodological limitations.
Aims: To examine the association between the receipt of PPIs and risk of COVID-19 hospitalizations and severe in-hospital outcomes or death.
Methods: Case-control study among Medicare fee-for-service beneficiaries 66+ years old with gastroesophageal reflux disorder (GERD). Within this population, we identified cases by an incident hospital discharge diagnosis of COVID-19 from April 1 to December 11, 2020, using the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) U07.1, and randomly selected up to 10 controls per case, matched on date and neighborhood. We defined PPI use as a prescription providing ≥15 days of supply in the 30 days before admission, with H2-receptor antagonist (H2RA) use as the reference to account for indication. We analyzed uncomplicated hospitalizations and hospitalizations with severe outcomes (intensive/coronary care unit admission, invasive mechanical ventilation, or death), estimating odds ratios (ORs), and 95% confidence intervals (CIs) with multinomial conditional logistic regression adjusted for demographics, comorbidities, chronic medications, and health care utilization.
Results: We matched 25,867 uncomplicated and 12,954 severe hospitalized COVID-19 cases to 146,972 and 73,104 controls, respectively. Cases tended to be older and have more comorbidities. Relative to H2RA use, we found no association of PPI use with uncomplicated COVID-19 hospitalization (OR 0.99, 95% CI 0.93-1.06) or severe COVID-19 hospitalization (OR 1.00, 95% CI 0.91-1.10).
Conclusions: Relative to H2RA use, PPI use was not associated with uncomplicated or severe COVID-19 hospitalizations among Medicare beneficiaries with GERD.
Keywords: COVID‐19; GERD; H2RA; PPI.
. 2024 Oct 18.
doi: 10.1002/phar.4614. Online ahead of print. Use of proton pump inhibitors and risk of severe COVID-19: A case-control study in United States Medicare beneficiaries
Andrew D Mosholder[SUP] 1 [/SUP], Hector S Izurieta[SUP] 2 [/SUP], Rongmei Zhang[SUP] 1 [/SUP], Shanlai Shangguan[SUP] 3 [/SUP], Yun Lu[SUP] 2 [/SUP], Sandia Akhtar[SUP] 3 [/SUP], Michael Wernecke[SUP] 3 [/SUP], Jiwei He[SUP] 1 [/SUP], Yoganand Chillarige[SUP] 3 [/SUP], Yuhui Feng[SUP] 3 [/SUP], Armen Avagyan[SUP] 3 [/SUP], Kira Leishear[SUP] 1 [/SUP], Richard A Forshee[SUP] 2 [/SUP], Thomas E MaCurdy[SUP] 3 4 [/SUP], Jeffrey A Kelman[SUP] 5 [/SUP], David J Graham[SUP] 1 [/SUP]
Affiliations
- PMID: 39425479
- DOI: 10.1002/phar.4614
Background: Concerns have been raised regarding proton pump inhibitor (PPI) use and risk of severe coronavirus disease 2019 (COVID-19). Observational studies have yielded heterogeneous results and were subject to important methodological limitations.
Aims: To examine the association between the receipt of PPIs and risk of COVID-19 hospitalizations and severe in-hospital outcomes or death.
Methods: Case-control study among Medicare fee-for-service beneficiaries 66+ years old with gastroesophageal reflux disorder (GERD). Within this population, we identified cases by an incident hospital discharge diagnosis of COVID-19 from April 1 to December 11, 2020, using the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) U07.1, and randomly selected up to 10 controls per case, matched on date and neighborhood. We defined PPI use as a prescription providing ≥15 days of supply in the 30 days before admission, with H2-receptor antagonist (H2RA) use as the reference to account for indication. We analyzed uncomplicated hospitalizations and hospitalizations with severe outcomes (intensive/coronary care unit admission, invasive mechanical ventilation, or death), estimating odds ratios (ORs), and 95% confidence intervals (CIs) with multinomial conditional logistic regression adjusted for demographics, comorbidities, chronic medications, and health care utilization.
Results: We matched 25,867 uncomplicated and 12,954 severe hospitalized COVID-19 cases to 146,972 and 73,104 controls, respectively. Cases tended to be older and have more comorbidities. Relative to H2RA use, we found no association of PPI use with uncomplicated COVID-19 hospitalization (OR 0.99, 95% CI 0.93-1.06) or severe COVID-19 hospitalization (OR 1.00, 95% CI 0.91-1.10).
Conclusions: Relative to H2RA use, PPI use was not associated with uncomplicated or severe COVID-19 hospitalizations among Medicare beneficiaries with GERD.
Keywords: COVID‐19; GERD; H2RA; PPI.