ArticleGut2021
Severe clinical outcomes of COVID-19 associated with proton pump inhibitors: a nationwide cohort study with propensity score matching.
Article in Gut, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 123 papers, 7 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
123 citing papers in PubMed, 7 syntheses or guidelines pooled it, 226 citations in OpenAlex.
- Pantoprazole and Vonoprazan Performed Well in Preventing Peptic Ulcer Recurrence in Low-Dose Aspirin Users.Digestive diseases and sciences · 2024Pooled it
- Acid suppressant use in association with incidence and severe outcomes of COVID-19: a systematic review and meta-analysis.European journal of clinical pharmacology · 2022Pooled it
- COVID-19, Anti-NMDA Receptor Encephalitis and MicroRNA.Frontiers in immunology · 2022Pooled it
- Proton pump inhibitor on susceptibility to COVID-19 and its severity: a systematic review and meta-analysis.Pharmacological reports : PR · 2021Pooled it
- Proton Pump Inhibitor Use Is Not Strongly Associated With SARS-CoV-2 Related Outcomes: A Nationwide Study and Meta-analysis.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2021Pooled it
- Proton Pump Inhibitors: Current Use and the Risk of Coronavirus Infectious Disease 2019 Development and its Related Mortality. Meta-analysis.Archives of medical research · 2021Pooled it
- Proton pump inhibitor use is associated with increased risk of severity and mortality from coronavirus disease 2019 (COVID-19) infection.Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver · 2020Pooled it
- Trial
- Protocol implementation during the COVID-19 pandemic: experiences from a randomized trial of stress ulcer prophylaxis.BMC medical research methodology · 2024Trial
- REVISE: re-evaluating the inhibition of stress erosions in the ICU-statistical analysis plan for a randomized trial.Trials · 2023Trial
- Severe Vision Impairment and Its Association with COVID-19 Susceptibility, Severity, and Mortality: A Population-Based Cohort Study.Journal of clinical medicine · 2026Article
- Severe COVID-19 in the Republic of Korea: Epidemiology, Risk Factors, Therapeutics, and Prognostic Models From Nationwide Data.Journal of Korean medical science · 2026Review
- All-Cause Mortality and Bleeding Risks Associated With Serotonin Reuptake Inhibitors in Patients With End-Stage Kidney Disease and Depression: A Nationwide Cohort Study.Psychiatry investigation · 2025Article
- Pre-hospital proton pump inhibitor use and clinical outcomes in hospitalized COVID-19 patients: A retrospective case-control study.World journal of virology · 2025Article
- Health risk assessment for severe COVID-19 in Taiwan: a multi-centre electronic health record study.Journal of global health · 2025Article
- Proton Pump Inhibitor Use in Older Adult Patients with Multiple Chronic Conditions: Clinical Risks and Best Practices.Journal of clinical medicine · 2025Review
- Antimicrobial and Anti-Efflux Machinery of FDA-Approved Proton Pump Inhibitors and Vitamins AgainstMicroorganisms · 2025Article
- Association between varicose veins and occurrence of dementia: A nationwide population-based cohort study.PloS one · 2025Article
- Pharmacodynamics, pharmacokinetics, interactions with other drugs, toxicity and clinical effectiveness of proton pump inhibitors.Frontiers in pharmacology · 2025Review
- Proton pump inhibitors and gastrointestinal symptoms among patients with COVID-19 infection.Annals of medicine · 2024Article
63 more citing papers are in PubMed but not listed here.
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Authors and funding
12 authors at 6 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe adverse effects of proton pump inhibitors (PPIs) have been documented for pneumonia; however, there is no consensus regarding whether the use of PPIs might be harmful regarding the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In this regard, we aimed to measure the potential associations of the current use of PPIs with the infection rates of COVID-19 among patients who underwent SARS-CoV-2 testing.
designData were derived from a Korean nationwide cohort study with propensity score matching. We included 132 316 patients older than 18 years who tested for SARS-CoV-2 between 1 January and 15 May 2020. Endpoints were SARS-CoV-2 positivity (primary) and severe clinical outcomes of COVID-19 (secondary: admission to intensive care unit, administration of invasive ventilation or death).
resultsIn the entire cohort, there were 111 911 non-users, 14 163 current PPI users and 6242 past PPI users. After propensity score matching, the SARS-CoV-2 test positivity rate was not associated with the current or past use of PPIs. Among patients with confirmed COVID-19, the current use of PPIs conferred a 79% greater risk of severe clinical outcomes of COVID-19, while the relationship with the past use of PPIs remained insignificant. Current PPI use starting within the previous 30 days was associated with a 90% increased risk of severe clinical outcomes of COVID-19.
conclusionPatients taking PPIs are at increased risk for severe clinical outcomes of COVID-19 but not susceptible to SARS-CoV-2 infection. This suggests that physicians need to assess benefit-risk assessments in the management of acid-related diseases amid the COVID-19 pandemic.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.