According to a new study, taking the common form of heartburn medications may moderately increase the risk of developing COVID-19.
Based on an online survey in which more than 86,600 and more than 3,300 captured COVID-19, the results show that those who took a proton pump inhibitor (PPI) could be about 2.2 to 3.7 times more likely than those who caught the virus Do not take that type of heartburn medication. The report was published on 7th July American Journal of Gastroenterology..
But before throwing a prescription, be aware that research can’t establish causality. Highlight only that Potential The link between the PPI and the chance of encountering COVID-19. To show that PPIs actually increase the likelihood of acquiring COVID-19, doctors looked at the medical records of patients with positive COVID-19 test results and found a disproportionately high number. Need to see if they are using the drug and exclude those patients not using it. Experts told Live Science that they didn’t share other features that could increase the risk of infection.
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“Never say people need to stop PPI,” said study author Dr Christopher Armario, a gastroenterologist and associate professor of medicine at Cedars-Sinai, a nonprofit academic institution in Los Angeles. I said. “We found the association here. This too needs to be confirmed.” Many US residents have severe acid reflux, heartburn, or Peptic ulcerAnd these people should not lower their doses or switch medications without first consulting a healthcare provider, Almario added.
“The last thing you want to do is panic for unnecessary reasons,” said Dhyanesh Arvind Patel, a gastroenterologist and associate professor of medicine at Vanderbilt University in Nashville, Tennessee, who wasn’t involved in the study. ..
The result of the survey, “I think it’s my feeling that there are many unmeasured confounders” is an unknown factor shared among PPI users, but unrelated to drug therapy, Means that the risk of may be increased.
Gastric acid as an immune defense
PPI reduces the amount of acid released into the stomach by permanently blocking the proton pump, a protein that drains positively charged molecules from gastric cells. According to Armario, both the cells of the stomach and the pump on its surface are continuously replaced, so when the blocked proton pump is replaced with a new one, the drug wears down.
According to textbooks, a single dose of PPI can inhibit about 90% acid production in 24 hoursMedical pharmacology and therapeutics“ (Elsevier Ltd., 2018). In practice, this means that PPI can maintain the stomach at a pH level of usually 6. (The pH scale ranges from 0 to 14, with 0 being the most acidic, 14 the least acidic, or the most alkaline. pH 6 is 1/1000 of pH 3.)
“These drugs Gastroesophageal reflux disease (GERD) and peptic ulcer, Patel said. However, while reducing stomach acid can be beneficial, it can also leave the intestine vulnerable to some infections.
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For example, getting a PPI once a day can increase the risk of your contract Clostridium difficile infection, According to the 2019 report in the journal Department of Gastroenterology.. Acids with a pH below 3 kill bacteria and protect the gut from harm. Similarly, acids below pH 3 interfere with the ability of SARS coronavirus, which causes severe acute respiratory syndrome, to infect cells in Petri dishes. Journal of Virology Methods.. SARS coronavirus, or SARS-CoV, caused the outbreak between 2002 and 2003.
“We are learning that COVID-19 can infect GI systems,” Almario said. Based on the findings of previous studies on the relevant coronavirus SARS-CoV, “Can reducing the acid in the stomach increase the probability of catching COVID?”
Huge salt grain
This question prompted Almario and his colleagues to conduct their research and participants were asked about their history. Stomach The condition and whether you were taking a less potent heartburn medication called a PPI or histamine 2 (H2) blocker. It blocks the complex histamine receptor, one of several substances that triggers the production of gastric acid.
Participants in the study were asked if they were tested for COVID-19 and, if so, positive. What symptoms They experienced. Those who started taking heartburn medications after being diagnosed with COVID-19 were classified as “non-users” because the treatment did not affect their chances of getting the virus.
The authors found that those who took PPIs were more likely to test positive for COVID-19 than those who took H2 blockers and those who did not take heartburn medications. Furthermore, those who took PPI twice daily were more likely to be positive than those who took once.
“The point is that the use of PPIs, especially the common but unapproved twice-daily dose, can increase the risk of #COVID19,” said author Cedars Sinai Health System Health Services. Public health at the University of California, Los Angeles, research director and professor of medicine, Tweeted July 7. “It’s always worth considering, especially if you need it twice a day. Especially vulnerable to severe illness“,” Elderly people and people with medical conditions”
That said, the findings may not be representative of all patients taking PPI, Patel said. “If you look at the demographics of the patient population, it’s a very disproportionate cohort,” he said.
Approximately 86% of those who tested positive for COVID-19 in this study were younger than 39 years, which does not reflect the distribution of COVID-19 infections across the population. There is no clear explanation as to why the use of PPIs makes young people at higher risk of infection than older people, suggesting that some confounders have skewed the results, he said. It was What is also strange is that the number of young patients who have been diagnosed with GERD, which is the main reason why young adults take PPI, is very low. This may reflect that people did not complete the survey correctly, but “we can’t confirm this information,” he said.
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Furthermore, the study did not suggest that PPI use was associated with an increased risk of severe gastrointestinal symptoms in people infected with COVID-19. PPI does not appear to alleviate COVID-19-related GI symptoms such as vomiting, nausea, and diarrhea.
To identify a potential link between PPI and COVID-19 risk, Patel said researchers need to collect data in hospitals or clinics where they can better control confounders. For example, a doctor can track if a COVID-19 patient taking PPI is severe. Stomach It is more common for people to have symptoms, be hospitalized, need supplemental oxygen, or die of the virus than people who are not taking the medication. If these trends turn out to be true, the follow-up question is whether the PPI can be linked to more severe respiratory symptoms, as the virus primarily attacks the respiratory system, he added. It was
Thoughts from other esophageal/gastrointestinal documents? Will this study change your clinical practice?July 8, 2020
About one in ten people in the US uses PPI, Patel said. Both he and Almario pointed out that PPI should be taken at the lowest dose possible, regardless of its association with COVID-19, to achieve therapeutic effects with minimal side effects. People taking 2 PPIs a day were both encouraged to check with their health care provider about the possibility of switching to a daily dose or a weak H2 blocker, especially if symptoms are suppressed.
“It’s just research, not research,” Patel said.
Originally published in Live Science.
