A study found that people who took proton pump inhibitors (PPIs) faced two to almost four times the risk of testing positive for COVID-19.
The study was published in the American Journal of Gastroenterology involved over 86,000 people, including 3,300 who tested positive for COVID-19.
“We found evidence of an independent, dose-response relationship between the use of anti secretory medications and COVID-19 positivity; individuals taking PPIs twice daily have higher odds for reporting a positive test when compared to those using PPIs up to once daily… further studies examining the association between PPIs and COVID-19 are needed,” the study said.
PPIs are medications which reduce the amount of stomach acid production. They are commonly used to treat heartburn. Nexium, Prilosec and Prevacid are examples of PPIs.
Dr. Brennan Spiegel of Cedars-Sinai Medical Center said the results aren’t a surprise because previous studies have showed that PPI use can be associated with a higher risk of some infections. Stomach acid is a mechanism by which the human body kills bacteria and viruses.
“There is a reason we have acid in our stomach, namely, to kill pathogens before they enter the digestive tract,” Spiegel said. “Coronaviruses are easily destroyed at a gastric pH of less than 3, but survive in a more neutral pH, including the range created by drugs like omeprazole and esomeprazole.”
Spiegel was surprised, though, by “just how large the effect seemed to be.”
“We found a biological gradient where the stronger the medicine, the higher the dose, the higher the effect for COVID-19,” Spiegel said.
“Viruses like SARS-CoV-2 are capable of hijacking the gastrointestinal tract quickly; we know that,” he said. “It can invade, replicate and multiply efficiently. There is even a theory that maybe it uses the intestines as a kind of home base where it entrenches itself and then spreads throughout the body.”
Spiegel stopped short of recommending that people should stop taking PPIs.
“This study does not mean that people on PPIs should just stop their medicines,” he said. “PPIs work and, in most cases, their benefits outweigh the risks.”
People taking a class of heartburn medication known as H2 blockers in the study failed to show a higher infection risk.
A recent letter to the editor sent to the Journal of Internal Medicine also said that there was evidence that PPI use may be associated with an increased risk of secondary infections and acute respiratory distress syndrome in COVID-19 patients who are hospitalized.
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