A recent research in the Gastroenterology journal fortified the safety of appropriate usage of proton pump inhibitors therapy during COVID-19. As found, the use of proton pump inhibitors was not significantly associated with augmented odds of positive severe acute respiratory syndrome-corona virus-2 (SARS-CoV-2) test. Anna L. Silverman et al. performed this case-control multicentre study to explore the possible link between proton pump inhibitors use and COVID-19 infection.

Utilizing a deidentified database of electronic health records data, it was estimated that 416 cases and controls each will be required to determine a two-fold relative risk in chronic proton pump inhibitors users in comparison with non-users with 80% power. From the collection of patient records related to a SARS-CoV-2 nasopharyngeal test, uniform sampling of 150 positive and 150 negative charts was done from each of three participating centers offering 900 records total.

Following a predefined chart review protocol, data was abstracted. The covariates with >40% missing data were eliminated, and multiple imputation was utilized. Chronic acid suppression was defined as the use of proton pump inhibitors daily or as needed for at least four weeks. A logistic regression model including backward and forward selection was carried out with 38 features including medical comorbidities, proton pump inhibitors usage, and demographic characteristics.

Among 861 medical records retained for assessment, about half were female, one-fifth were above the age of 65, and about 71% had a Charlson comorbidity index of 0-2. The final model retained 13 features and proton pump inhibitors were manually incorporated. The usage of proton pump inhibitors did not raise the odds of SARS-COV-2 positivity (odds ratio 1.02).

On the other hand, body mass index ≥ 30, HIV, diabetes, and dementia were linked with a raised risk of coronavirus infection. A past history of alcohol usage disorder, presence of solid tumor, healthcare worker employment, and female sex were found to be linked with a negative test. Tests earlier in the study period were more likely to be positive.

Though the study population was relatively young having a small burden of medical comorbidities, preexisting diabetes, obesity, HIV, and dementia were reported to raise the risk of positive SARS-CoV-2 test. Additional prospective validation is warranted to further evaluate these outcomes.