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Published on: May 25, 2017
Proton pump inhibitors use prior to COVID-19 hospitalization is associated with higher Clostridioides difficile
Marko Lucijanic1,2, Nikolina Busic3, Josip Stojic4
1Hematology Department, University Hospital Dubrava, Zagreb, Croatia.
Insights
Prior proton pump inhibitor (PPI) use in COVID-19 patients was linked to increased Clostridioides difficile infections but not higher mortality. PPI use may increase complication risks during SARS-CoV-2 infection treatment.
Area of Science:
- Infectious Diseases
- Gastroenterology
- Pharmacology
Background:
- Uncertainty exists regarding proton pump inhibitor (PPI) use and COVID-19 susceptibility and severity.
- Prior PPI use associations with SARS-CoV-2 infection risks require further investigation.
Purpose of the Study:
- To evaluate the association between prior PPI use and outcomes in hospitalized COVID-19 patients.
- To determine if PPI use impacts mortality, mechanical ventilation, ICU stay, thrombosis, bleeding, bacteremia, or C. difficile infection.
Main Methods:
- Retrospective evaluation of 5959 hospitalized COVID-19 patients (March 2020 - June 2021).
- Analysis of outcomes including in-hospital mortality, mechanical ventilation, ICU stay, thromboembolism, bleeding, bacteremia, and C. difficile infection.
- Comparison between entire and case-matched cohorts.
Main Results:
- 33% of patients (1967/5959) were prior PPI users.
- In the entire cohort, PPI use correlated with higher mortality and C. difficile infection (C. diff.).
- After adjustments, PPI use remained associated with C. diff. but not mortality; matched cohort showed only increased C. diff. risk.
Conclusions:
- Prior PPI use may not significantly affect SARS-CoV-2 clinical course or mortality.
- PPI use might predispose patients to complications like C. difficile infection.
- PPI use can substantially impact COVID-19 treatment course through increased complication risks.
Background:
There are uncertainties regarding associations of prior proton pump inhibitor (PPI) use with susceptibility for COVID-19 and risks associated with SARS-CoV-2 infection. We aimed to evaluate the associations of prior PPI use with outcomes in hospitalized patients with COVID-19.
Research Design And Methods:
We have retrospectively evaluated a total of 5959 consecutively hospitalized patients with COVID-19 from a tertiary-level institution in the period 3/2020-6/2021. Associations of prior PPI use with outcomes of in-hospital mortality, mechanical ventilation, intensive care unit stay, venous thromboembolism, arterial thrombosis, major bleeding, bacteremia, and Clostridioides difficile infection (C. diff.) were evaluated in entire and case-matched cohorts.
Results:
Among 5959 evaluated patients, there were 1967 (33%) PPI users. In an entire cohort, prior PPI use was associated with higher in-hospital mortality and higher occurrence of C. diff. Association of prior PPI use with mortality diminished, whereas association with C. diff. persisted after multivariable adjustments. In a matched cohort, prior PPI use was associated only with higher risk of C. diff. but not other outcomes in line with multivariable analysis.
Conclusions:
Although prior PPI use might not have a significant impact on clinical course and mortality of SARS-CoV-2 infection, it may predispose patients to the development of complications like higher occurrence of C. diff. and thus substantially impact the course of treatment.
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