The Proton Pump Inhibitors Use and COVID-19 from Prior to Vaccination Perspective: A Review

Area of Science:

• Gastroenterology
• Infectious Diseases
• Pharmacology

Background:

• COVID-19, caused by SARS-CoV-2, presents global health challenges.
• Proton pump inhibitors (PPIs) were investigated for potential links to COVID-19 risk and outcomes before widespread vaccination.
• This review examines the complex relationship between PPI use and SARS-CoV-2 infection.

Purpose of the Study:

• To review the uncertain role of PPIs in SARS-CoV-2 infection and COVID-19 clinical course.
• To evaluate PPI indications in the context of COVID-19 before mass vaccination.
• To synthesize existing data on PPIs' impact on COVID-19.

Main Methods:

• Literature review of studies on PPIs, SARS-CoV-2, and COVID-19.
• Analysis of data regarding PPIs' effects on gastric acid secretion and immunity.
• Evaluation of PPIs' role in managing COVID-19 complications.

Main Results:

• Published data on PPIs' association with SARS-CoV-2 positivity and COVID-19 severity remain inconclusive.
• PPIs are well-documented in preventing upper gastrointestinal bleeding, crucial for many COVID-19 patients on antiplatelet/anticoagulant therapy.
• PPIs show potential as repurposed antiviral agents, warranting further investigation for COVID-19 pharmacotherapy.

Conclusions:

• Despite controversial past claims, PPIs should not be withheld for established clinical indications.
• Iatrogenic hypochlorhydria from PPIs may impact immunity, but this is outweighed by benefits in specific patient groups.
• PPIs warrant further study as a potential therapeutic strategy against SARS-CoV-2.