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Proton pump inhibitor or famotidine use and severe COVID-19 disease: a propensity score-matched territory-wide study
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  1. Jiandong Zhou1,
  2. Xiansong Wang2,
  3. Sharen Lee3,
  4. William Ka Kei Wu2,
  5. Bernard Man Yung Cheung4,
  6. Qingpeng Zhang1,
  7. Gary Tse5
  1. 1School of Data Science, City University of Hong Kong, Kowloon, Hong Kong
  2. 2Department of Anaesthesia and Intensive Care, Li Ka Shing Institute of Health Sciences, Hong Kong, China
  3. 3Cardiovascular Analytics Group, Laboratory of Cardiovascular Physiology, Hong Kong, China
  4. 4Department of Medicine, The University of Hong Kong, Hong Kong, China
  5. 5Tianjin Institute of Cardiology, Tianjin Medical University, Tianjin, China
  1. Correspondence to Professor Gary Tse, Tianjin Institute of Cardiology, Tianjin Medical University, Tianjin 300070, China; garytse86{at}gmail.com; Professor Qingpeng Zhang, School of Data Science, City University of Hong Kong, Hong Kong, China; qingpeng.zhang{at}cityu.edu.hk

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We read the recent articles published in Gut on the relationship between proton pump inhibitor (PPI) use and outcomes in COVID-19 with great interest.1 2 In the meta-analysis, the authors found that current or regular PPI users were more likely to have severe outcomes of COVID-19 than non-users, but no significant association was observed for previous PPI use.2 The reason may be reduced secretion of gastric acid that can neutralise the SARS-CoV-2. By contrast, the use of famotidine, another medication for gastric ulcers or gastro-oesophageal reflux disease, was associated with better clinical outcomes in some studies,3 4 but not others.5 6

Given these conflicting findings, we conducted this territory-wide study to investigate whether PPI or famotidine use was associated with a higher risk of severe disease using propensity score matching. The detailed methodology of the present analyses is shown in the online supplemental appendix. A total of 4445 patients (median age 44.8 years old, 95% CI: (28.9 to 60.8)); 50% male) were diagnosed with the COVID-19 infection between 1 January 2020 and 22 August 2020 in Hong Kong public hospitals or their associated ambulatory/outpatient facilities. On follow-up until 8 September 2020, a total of …

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