Do proton pump inhibitors influence SARS-CoV-2 related outcomes? A meta-analysis

The article by Lee et al 1 showed that the current use of proton pump inhibitors (PPIs) increased the risk of severe clinical outcomes of COVID-19 rather than the susceptibility to SARS-CoV-2 infection in a Korean nationwide cohort. Instead, a significant association between susceptibility to SARS-CoV-2 infection and current use of PPIs, either one time or two times a day, was found by another recent study2 based on US nationwide data. The conflicting results of these two large-scale observational studies may be due to regional epidemiological differences or considerable between-study variance and might compromise clinical decision-making. As the impact of PPI use on SARS-CoV-2 infection has very relevant clinical implications, we performed a meta-analysis to address the aforementioned discrepancies, which could lead to better informed clinical decision-making on PPI use during the ongoing pandemic. We scrutinised 3413 records retrieved from a comprehensive search using the COVID-19 Research Articles Downloadable Database maintained by the US CDC (https://www.cdc.gov/library/researchguides/2019novelcoronavirus/researcharticles.html) and ultimately included 16 studies1–16 from 10 countries or regions reporting comparative data on PPI use and clinical outcomes of COVID-19 (online supplemental figure 1 and table). We pooled the …