TY - JOUR T1 - Severe clinical outcomes of COVID-19 associated with proton pump inhibitors: a nationwide cohort study with propensity score matching JF - Gut JO - Gut SP - 76 LP - 84 DO - 10.1136/gutjnl-2020-322248 VL - 70 IS - 1 AU - Seung Won Lee AU - Eun Kyo Ha AU - Abdullah Özgür Yeniova AU - Sung Yong Moon AU - So Young Kim AU - Hyun Yong Koh AU - Jee Myung Yang AU - Su Jin Jeong AU - Sun Joon Moon AU - Joo Young Cho AU - In Kyung Yoo AU - Dong Keon Yon Y1 - 2021/01/01 UR - http://gut.bmj.com/content/70/1/76.abstract N2 - Objective The adverse effects of proton pump inhibitors (PPIs) have been documented for pneumonia; however, there is no consensus regarding whether the use of PPIs might be harmful regarding the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In this regard, we aimed to measure the potential associations of the current use of PPIs with the infection rates of COVID-19 among patients who underwent SARS-CoV-2 testing.Design Data were derived from a Korean nationwide cohort study with propensity score matching. We included 132 316 patients older than 18 years who tested for SARS-CoV-2 between 1 January and 15 May 2020. Endpoints were SARS-CoV-2 positivity (primary) and severe clinical outcomes of COVID-19 (secondary: admission to intensive care unit, administration of invasive ventilation or death).Results In the entire cohort, there were 111 911 non-users, 14 163 current PPI users and 6242 past PPI users. After propensity score matching, the SARS-CoV-2 test positivity rate was not associated with the current or past use of PPIs. Among patients with confirmed COVID-19, the current use of PPIs conferred a 79% greater risk of severe clinical outcomes of COVID-19, while the relationship with the past use of PPIs remained insignificant. Current PPI use starting within the previous 30 days was associated with a 90% increased risk of severe clinical outcomes of COVID-19.Conclusion Patients taking PPIs are at increased risk for severe clinical outcomes of COVID-19 but not susceptible to SARS-CoV-2 infection. This suggests that physicians need to assess benefit–risk assessments in the management of acid-related diseases amid the COVID-19 pandemic. ER -