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Proton Pump Inhibitors are Risk Factors for Viral Infections: Even for COVID-19?

Bruno Charpiat1, Nathalie Bleyzac2,3, Michel Tod2,3

  • 1Service Pharmacie, Hôpital de La Croix-Rousse, Groupement Hospitalier Nord, Hospices Civils de Lyon, 103 Grande Rue de la Croix-Rousse, 69004, Lyon, France. bruno.charpiat@chu-lyon.fr.

Clinical Drug Investigation
|August 12, 2020
PubMed

Insights

Proton pump inhibitors (PPIs) may increase the risk of SARS-CoV-2 infection. Reduced stomach acid from PPIs might hinder the body's defense against ingested viruses like SARS-CoV-2.

Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Pharmacology

Background:

  • Gastric acid plays a crucial role in inactivating ingested pathogens.
  • Proton pump inhibitors (PPIs) reduce gastric acid production.
  • Previous studies link PPIs to increased risk of viral infections like rotavirus, norovirus, and MERS-CoV.

Purpose of the Study:

  • To evaluate the potential increased risk of SARS-CoV-2 infection in patients using proton pump inhibitors.
  • To highlight the importance of risk-benefit assessment for PPIs during the COVID-19 pandemic.

Main Methods:

  • This study is a review and hypothesis generation based on existing literature.
  • Analysis of the known mechanisms of gastric acid in pathogen defense.
  • Correlation of PPI use with documented risks of other viral infections.

Main Results:

  • Proton pump inhibitors may compromise the natural defense mechanism of gastric acid against swallowed microorganisms.
  • Evidence suggests PPIs are associated with increased susceptibility to enteric and respiratory viral infections.
  • The fecal-oral transmission route of SARS-CoV-2 supports the potential for gastrointestinal entry.

Conclusions:

  • Patients treated with proton pump inhibitors may be at a higher risk of SARS-CoV-2 infection.
  • Further research is warranted to confirm the association between PPI use and COVID-19 susceptibility.
  • Clinicians should carefully consider the risks and benefits of prescribing PPIs during the pandemic.

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