Use of proton pump inhibitors and risk of severe COVID-19: A case-control study in United States Medicare beneficiaries.

IF 2.9 3区 医学 Q2 PHARMACOLOGY & PHARMACY
Pharmacotherapy Pub Date : 2024-10-01 Epub Date: 2024-10-18 DOI:10.1002/phar.4614
Andrew D Mosholder, Hector S Izurieta, Rongmei Zhang, Shanlai Shangguan, Yun Lu, Sandia Akhtar, Michael Wernecke, Jiwei He, Yoganand Chillarige, Yuhui Feng, Armen Avagyan, Kira Leishear, Richard A Forshee, Thomas E MaCurdy, Jeffrey A Kelman, David J Graham
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引用次数: 0

Abstract

Background: Concerns have been raised regarding proton pump inhibitor (PPI) use and risk of severe coronavirus disease 2019 (COVID-19). Observational studies have yielded heterogeneous results and were subject to important methodological limitations.

Aims: To examine the association between the receipt of PPIs and risk of COVID-19 hospitalizations and severe in-hospital outcomes or death.

Methods: Case-control study among Medicare fee-for-service beneficiaries 66+ years old with gastroesophageal reflux disorder (GERD). Within this population, we identified cases by an incident hospital discharge diagnosis of COVID-19 from April 1 to December 11, 2020, using the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) U07.1, and randomly selected up to 10 controls per case, matched on date and neighborhood. We defined PPI use as a prescription providing ≥15 days of supply in the 30 days before admission, with H2-receptor antagonist (H2RA) use as the reference to account for indication. We analyzed uncomplicated hospitalizations and hospitalizations with severe outcomes (intensive/coronary care unit admission, invasive mechanical ventilation, or death), estimating odds ratios (ORs), and 95% confidence intervals (CIs) with multinomial conditional logistic regression adjusted for demographics, comorbidities, chronic medications, and health care utilization.

Results: We matched 25,867 uncomplicated and 12,954 severe hospitalized COVID-19 cases to 146,972 and 73,104 controls, respectively. Cases tended to be older and have more comorbidities. Relative to H2RA use, we found no association of PPI use with uncomplicated COVID-19 hospitalization (OR 0.99, 95% CI 0.93-1.06) or severe COVID-19 hospitalization (OR 1.00, 95% CI 0.91-1.10).

Conclusions: Relative to H2RA use, PPI use was not associated with uncomplicated or severe COVID-19 hospitalizations among Medicare beneficiaries with GERD.

使用质子泵抑制剂与严重 COVID-19 的风险:美国医疗保险受益人病例对照研究。
背景:人们对质子泵抑制剂(PPI)的使用和2019年严重冠状病毒病(COVID-19)的风险表示担忧。目的:研究服用 PPI 与 COVID-19 住院风险、严重住院后果或死亡之间的关系:在 66 岁以上患有胃食管反流症 (GERD) 的医疗保险付费服务受益人中开展病例对照研究。在这一人群中,我们根据 2020 年 4 月 1 日至 12 月 11 日期间出院诊断为 COVID-19 的病例(采用国际疾病分类第十版临床修正版(ICD-10-CM)U07.1)来确定病例,并为每个病例随机选取多达 10 个对照,在日期和邻里关系上进行匹配。我们将 PPI 的使用定义为入院前 30 天内提供≥15 天用量的处方,并以 H2 受体拮抗剂 (H2RA) 的使用作为参考,以确定其适应症。我们分析了无并发症住院和有严重后果(入住重症监护室/冠心病监护室、有创机械通气或死亡)的住院情况,并根据人口统计学、合并症、慢性药物和医疗保健使用情况进行了调整,通过多项式条件逻辑回归估算出了几率比(OR)和 95% 置信区间(CI):我们将 25,867 例无并发症的 COVID-19 病例和 12,954 例严重的 COVID-19 住院病例分别与 146,972 例和 73,104 例对照病例进行了配对。病例往往年龄较大,合并症较多。与使用 H2RA 相比,我们发现使用 PPI 与无并发症的 COVID-19 住院治疗(OR 0.99,95% CI 0.93-1.06)或严重的 COVID-19 住院治疗(OR 1.00,95% CI 0.91-1.10)没有关联:结论:在患有胃食管反流病的医疗保险受益人中,相对于 H2RA 的使用,PPI 的使用与非复杂性或严重 COVID-19 住院治疗无关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Pharmacotherapy
Pharmacotherapy 医学-药学
CiteScore
7.80
自引率
2.40%
发文量
93
审稿时长
4-8 weeks
期刊介绍: Pharmacotherapy is devoted to publication of original research articles on all aspects of human pharmacology and review articles on drugs and drug therapy. The Editors and Editorial Board invite original research reports on pharmacokinetic, bioavailability, and drug interaction studies, clinical trials, investigations of specific pharmacological properties of drugs, and related topics.
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