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质子泵抑制剂治疗的使用与 COVID-19 患者相关的住院率和重症监护结局。

Proton pump inhibitor therapy usage and associated hospitalization rates and critical care outcomes of COVID-19 patients.

机构信息

Internal Medicine Resident, St. Luke's University Health Network, Bethlehem, PA, USA.

Division of Internal Medicine, St. Luke's University Health Network, 801 Ostrum St., Suite 201, Bethlehem, 18015, PA, USA.

出版信息

Sci Rep. 2022 May 9;12(1):7596. doi: 10.1038/s41598-022-11680-0.

Abstract

Proton Pump Inhibitors (PPI) are one of the most prescribed medications in the United States. However, PPIs have been shown to increase the risk of enteric infections. Our study aims to evaluate the correlation between PPI and COVID-19 severity. We performed a retrospective cohort study on patients who tested positive for SARS-CoV-2 from March to August 2020. Patients were categorized based on PPI user status. Primary outcomes included need for hospital or ICU admission and 30-day mortality. Secondary outcomes looked to determine the severity of COVID-19 infection and effect of comorbid conditions. 2,594 patients were reviewed. The primary outcomes of our study found that neither active nor past PPI use was associated with increased hospital admission or 30-day mortality following completion of multivariate analysis. Additionally, there was no association between COVID-19 infection and the strength of PPI dosing (low, standard, high). However, the following covariates were independently and significantly associated with increased admission: age, male gender, diabetes, COPD, composite cardiovascular disease, kidney disease, and obesity. The following covariates were associated with increased mortality: age, male gender, COPD, and kidney disease. In conclusion, the high risk features and comorbidities of PPI users were found to have a stronger correlation to severe COVID-19 infection and poor outcomes as opposed to the use of PPI therapy.

摘要

质子泵抑制剂(PPI)是美国最常开的药物之一。然而,PPI 已被证明会增加肠内感染的风险。我们的研究旨在评估 PPI 与 COVID-19 严重程度之间的相关性。我们对 2020 年 3 月至 8 月期间 SARS-CoV-2 检测呈阳性的患者进行了回顾性队列研究。患者根据 PPI 使用情况进行分类。主要结局包括需要住院或 ICU 入院以及 30 天死亡率。次要结局旨在确定 COVID-19 感染的严重程度和合并症的影响。共回顾了 2594 名患者。我们的研究主要结局发现,无论是积极使用还是过去使用 PPI,与多变量分析完成后住院或 30 天死亡率增加均无关。此外,COVID-19 感染与 PPI 剂量(低、标准、高)之间也没有关联。然而,以下协变量与住院增加独立且显著相关:年龄、男性、糖尿病、COPD、复合心血管疾病、肾脏疾病和肥胖。以下协变量与死亡率增加相关:年龄、男性、COPD 和肾脏疾病。总之,与 PPI 使用者的高风险特征和合并症相比,PPI 治疗与严重 COVID-19 感染和不良结局的相关性更强。

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本文引用的文献

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