T. Yip, F. Chan, G. Lui, V. Wong, H. Chan, S. Wong, J. Mak, S. Ng, D. S. Hui, G. Wong
{"title":"质子泵抑制剂的使用与COVID-19患者的不良临床结果无关:一项区域性队列研究","authors":"T. Yip, F. Chan, G. Lui, V. Wong, H. Chan, S. Wong, J. Mak, S. Ng, D. S. Hui, G. Wong","doi":"10.1155/2022/8803862","DOIUrl":null,"url":null,"abstract":"Background. Evidence regarding the use of proton-pump inhibitors (PPIs) in COVID-19 patients remains elusive. Aim. To examine the potential effects of PPI use on the clinical outcomes of COVID-19 patients in a territory-wide cohort. Methods. A retrospective cohort study was performed using data from a territory-wide database in Hong Kong. Patients diagnosed with COVID-19 from 23 January 2020 to 1 January 2021 were identified by virological results. The primary endpoint was a composite of intensive care unit admission, use of invasive mechanical ventilation, and/or death. PPI users were identified by PPI use within 12 months prior to their diagnosis of COVID-19. Results. We identified 8,675 COVID-19 patients (mean age 46 years, 49% male, 97.6% of all reported cases in Hong Kong), of which 579 (6.7%) patients had used PPI. PPI users were found to be older, more likely to have comorbidities, concomitant medications and unfavourable laboratory parameters than nonusers. Of the 8,675 COVID-19 patients, 500 (5.8%) developed the primary endpoint. After propensity score (PS) balancing for patients’ demographics, comorbidities, laboratory parameters, and use of medications, PPI use was not found to be associated with the development of primary endpoint in PS weighting (weighted hazard ratio (HR) 1.10, 95% confidence interval (CI) 0.82–1.46, \n \n P\n =\n 0.529\n \n ), and PS matching analysis (weighted HR 0.79, 95% CI 0.56–1.13, \n \n P\n =\n 0.198\n \n ). Consistent nonassociation was observed after multivariable adjustment (adjusted HR 0.84, 95% CI 0.67–1.06, \n \n P\n =\n 0.142\n \n ), and in subgroups of current and past PPI users. Conclusion. PPI use is not found to be associated with adverse clinical outcomes in COVID-19 patients. The result remains robust after PS weighting, PS matching, and multivariable adjustment.","PeriodicalId":12480,"journal":{"name":"GastroHep","volume":"12 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2022-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Use of Proton-Pump Inhibitor Is Not Associated with Adverse Clinical Outcomes in COVID-19 Patients: A Territory-Wide Cohort Study\",\"authors\":\"T. Yip, F. Chan, G. Lui, V. Wong, H. Chan, S. Wong, J. Mak, S. Ng, D. S. Hui, G. Wong\",\"doi\":\"10.1155/2022/8803862\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background. Evidence regarding the use of proton-pump inhibitors (PPIs) in COVID-19 patients remains elusive. Aim. To examine the potential effects of PPI use on the clinical outcomes of COVID-19 patients in a territory-wide cohort. Methods. A retrospective cohort study was performed using data from a territory-wide database in Hong Kong. Patients diagnosed with COVID-19 from 23 January 2020 to 1 January 2021 were identified by virological results. The primary endpoint was a composite of intensive care unit admission, use of invasive mechanical ventilation, and/or death. PPI users were identified by PPI use within 12 months prior to their diagnosis of COVID-19. Results. We identified 8,675 COVID-19 patients (mean age 46 years, 49% male, 97.6% of all reported cases in Hong Kong), of which 579 (6.7%) patients had used PPI. PPI users were found to be older, more likely to have comorbidities, concomitant medications and unfavourable laboratory parameters than nonusers. Of the 8,675 COVID-19 patients, 500 (5.8%) developed the primary endpoint. After propensity score (PS) balancing for patients’ demographics, comorbidities, laboratory parameters, and use of medications, PPI use was not found to be associated with the development of primary endpoint in PS weighting (weighted hazard ratio (HR) 1.10, 95% confidence interval (CI) 0.82–1.46, \\n \\n P\\n =\\n 0.529\\n \\n ), and PS matching analysis (weighted HR 0.79, 95% CI 0.56–1.13, \\n \\n P\\n =\\n 0.198\\n \\n ). Consistent nonassociation was observed after multivariable adjustment (adjusted HR 0.84, 95% CI 0.67–1.06, \\n \\n P\\n =\\n 0.142\\n \\n ), and in subgroups of current and past PPI users. Conclusion. PPI use is not found to be associated with adverse clinical outcomes in COVID-19 patients. The result remains robust after PS weighting, PS matching, and multivariable adjustment.\",\"PeriodicalId\":12480,\"journal\":{\"name\":\"GastroHep\",\"volume\":\"12 1\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-01-31\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"GastroHep\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1155/2022/8803862\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"GastroHep","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1155/2022/8803862","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
背景。关于在COVID-19患者中使用质子泵抑制剂(PPIs)的证据仍然难以捉摸。的目标。在全港队列中研究PPI使用对COVID-19患者临床结局的潜在影响。方法。一项回顾性队列研究使用了香港一个全地区数据库的数据。根据病毒学结果确定了2020年1月23日至2021年1月1日诊断为COVID-19的患者。主要终点是重症监护病房入住、使用有创机械通气和/或死亡。PPI使用者在诊断为COVID-19之前的12个月内使用PPI。结果。我们确定了8,675例COVID-19患者(平均年龄46岁,49%为男性,占香港所有报告病例的97.6%),其中579例(6.7%)患者使用过PPI。研究发现,PPI使用者年龄较大,比非使用者更容易出现合并症、伴随用药和不利的实验室参数。在8675例COVID-19患者中,500例(5.8%)达到了主要终点。在对患者的人口统计学、合并症、实验室参数和药物使用进行倾向评分(PS)平衡后,在PS加权(加权风险比(HR) 1.10, 95%可信区间(CI) 0.82-1.46, P = 0.529)和PS匹配分析(加权HR 0.79, 95% CI 0.56-1.13, P = 0.198)中,PPI的使用未发现与主要终点的发展相关。在多变量调整后(调整后危险度0.84,95% CI 0.67-1.06, P = 0.142),在当前和过去PPI使用者亚组中观察到一致的无关联。结论。未发现使用PPI与COVID-19患者的不良临床结果相关。经过PS加权、PS匹配和多变量调整后,结果仍然具有鲁棒性。
Use of Proton-Pump Inhibitor Is Not Associated with Adverse Clinical Outcomes in COVID-19 Patients: A Territory-Wide Cohort Study
Background. Evidence regarding the use of proton-pump inhibitors (PPIs) in COVID-19 patients remains elusive. Aim. To examine the potential effects of PPI use on the clinical outcomes of COVID-19 patients in a territory-wide cohort. Methods. A retrospective cohort study was performed using data from a territory-wide database in Hong Kong. Patients diagnosed with COVID-19 from 23 January 2020 to 1 January 2021 were identified by virological results. The primary endpoint was a composite of intensive care unit admission, use of invasive mechanical ventilation, and/or death. PPI users were identified by PPI use within 12 months prior to their diagnosis of COVID-19. Results. We identified 8,675 COVID-19 patients (mean age 46 years, 49% male, 97.6% of all reported cases in Hong Kong), of which 579 (6.7%) patients had used PPI. PPI users were found to be older, more likely to have comorbidities, concomitant medications and unfavourable laboratory parameters than nonusers. Of the 8,675 COVID-19 patients, 500 (5.8%) developed the primary endpoint. After propensity score (PS) balancing for patients’ demographics, comorbidities, laboratory parameters, and use of medications, PPI use was not found to be associated with the development of primary endpoint in PS weighting (weighted hazard ratio (HR) 1.10, 95% confidence interval (CI) 0.82–1.46,
P
=
0.529
), and PS matching analysis (weighted HR 0.79, 95% CI 0.56–1.13,
P
=
0.198
). Consistent nonassociation was observed after multivariable adjustment (adjusted HR 0.84, 95% CI 0.67–1.06,
P
=
0.142
), and in subgroups of current and past PPI users. Conclusion. PPI use is not found to be associated with adverse clinical outcomes in COVID-19 patients. The result remains robust after PS weighting, PS matching, and multivariable adjustment.