Evidence map›Paper›PMID 42674788›Full record

Trial reportBMJ open2026

Proton pump inhibitors in invasively ventilated patients with SARS-CoV-2: a substudy of the re-evaluating the inhibition of stress erosions trial.

Brittany Dennis, Diane Heels-Ansdell, Quazi Ibrahim, John Basmaji, Lehana Thabane, Gordon Guyatt, Lois Saunders, Lori Hand, Olivia Loy, Nicole Zytaruk and 22 more

2 registry-linked trialsAbstract readRandomized Controlled TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT03374800 phase3completednot on this map

Re-EValuating the Inhibition of Stress Erosions: Prophylaxis Against Gastrointestinal Bleeding in the Critically Ill (The REVISE) Trial

TypeinterventionalSponsorMcMaster UniversityRan2018 to 2024Enrolled4,800ConditionsGastrointestinal Hemorrhage (Clinically Important, Upper)ArmsPlacebo (0.9% saline), Pantoprazole
NCT05715567 unknown statusnot on this map

Re-EValuating the Inhibition of Stress Erosions (REVISE) - COVID-19 Cohort Study

TypeobservationalSponsorMcMaster UniversityRan2021 to 2024Enrolled600ConditionsCOVID-19, GastroIntestinal BleedingArmsRe-EValuating the Inhibition of Stress Erosions (REVISE) Trial (NCT03374800)
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

32 authors.

Brittany DennisDepartment of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada.
Diane Heels-AnsdellDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.ORCID 0000-0003-4362-801X
Quazi IbrahimDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
John BasmajiDepartment of Medicine, Division of Critical Care, Western University, London, Ontario, Canada.
Lehana ThabaneDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.ORCID 0000-0003-0355-9734
Gordon GuyattDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
Lois SaundersSt. Joseph's Research Institute, Hamilton, Ontario, Canada.
Lori HandDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
Olivia LoyDepartment of Critical Care, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia.
Nicole ZytarukDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
Miranda HardieCritical Care Program, The George Institute for Global Health, Sydney, New South Wales, Australia.
Adam M DeaneDepartment of Critical Care, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia.ORCID 0000-0002-7620-5577
John C MarshallInterdepartmental Division of Critical Care, University of Toronto, Toronto, Ontario, Canada.ORCID 0000-0002-7902-6291
Yaseen ArabiIntensive Care Department, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.
François LauzierDepartments of Anesthesiology, Medicine and Critical Care Medicine, Laval University, Québec City, Quebec, Canada.
Joanna C DionneDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
Karen Ea BurnsInterdepartmental Division of Critical Care, University of Toronto, Toronto, Ontario, Canada.ORCID 0000-0002-9967-5424
Waleed AlhazzaniCritical Care and Internal Medicine Department, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
Gloria Vazquez-GrandeDepartment of Critical Care, University of Manitoba, Winnipeg, Manitoba, Canada.
Anna GeageaCritical Care, North York General Hospital, Toronto, Ontario, Canada.
John MyburghCritical Care Program, The George Institute for Global Health, Sydney, New South Wales, Australia.
John MuscedereCritical Care Medicine, Queen's University, Kingston, Ontario, Canada.ORCID 0000-0002-9027-7198
Shane EnglishDepartment of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Alexandra BinnieDepartment of Critical Care Medicine, William Osler Health System, Brampton, Ontario, Canada.
Jennifer Ly TsangMedicine, McMaster University, Hamilton, Ontario, Canada.
Miranda HuntCritical Care Medicine, Queen's University, Kingston, Ontario, Canada.
Marlies OstermannDepartment of Critical Care, King's College London, Guy's & St Thomas' Hospital, London, UK.
Abdulrahman A Al-FaresDepartment of Anesthesia, Critical Care, Pain Medicine and Kuwait Extracorporeal Life Support, Al-Amiri Hospital, Kuwait City, Kuwait.ORCID 0000-0001-9475-7976
Serena KnowlesCritical Care Program, The George Institute for Global Health, Sydney, New South Wales, Australia.
Aijaz AhmedDepartment of Gastroenterology & Hepatology, Stanford University, Stanford, California, US.
Deborah J CookDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada debcook@mcmaster.ca.ORCID 0000-0002-4087-543X
REVISE Investigators and the Canadian Critical Care Trials Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesObservational studies suggest that acid suppression may worsen outcomes among patients infected with SARS-CoV-2. The objectives of this embedded substudy of a randomised controlled trial evaluating pantoprazole in mechanically ventilated patients were to (1) describe the clinical characteristics of critically ill patients with SARS-CoV-2, (2) compare clinical outcomes with a propensity-matched non-infected cohort and (3) assess whether pantoprazole's treatment effects differed by SARS-CoV-2 infection status.

designA pre-planned substudy of the re-evaluating the inhibition of stress erosions (REVISE) trial, including a propensity-matched analysis of infected and non-infected patients comparing the effect of pantoprazole between patients with and without SARS-CoV-2.

setting68 intensive care units (ICUs) in eight countries.

participantsFrom July 2019 to October 2023, 4821 eligible participants were enrolled in REVISE whether or not they had SARS-CoV-2 infection. PRIMARY AND SECONDARY OUTCOME MEASURES: Participants enrolled in REVISE with SARS-CoV-2 infection had additional data collection, including biomarkers, venous thromboembolism, SARS-CoV-2 therapies and tracheostomy timing. The primary outcomes were clinically important upper gastrointestinal bleeding and 90-day mortality. Secondary outcomes included ventilator-associated pneumonia,

resultsOf the eligible trial cohort, 11.9% (540/4550) had SARS-CoV-2; 532 patients had additional SARS-CoV-2-specific data collection. Of these 532 patients, 87.8% received COVID-19-directed treatments-(dexamethasone 75.2%), 11.7% developed pulmonary embolism and 9.2% developed deep-vein thrombosis. After propensity matching, SARS-CoV-2 infection was not associated with clinically important upper gastrointestinal bleeding (adjusted HR 0.78, 95% CI 0.40 to 1.50) but was associated with significantly higher ICU, hospital and 90-day mortality, as well as longer duration of ventilation and ICU and hospital length of stay. The effect of pantoprazole on clinically important upper GI bleeding and 90-day mortality was consistent regardless of SARS-CoV-2 status.

conclusionsSARS-CoV-2 infection was associated with higher mortality and longer duration of mechanical ventilation, ICU and hospital stays, without an increased risk of clinically important upper gastrointestinal bleeding. Pantoprazole reduced clinically important upper gastrointestinal bleeding without adversely affecting other outcomes. TRIAL REGISTRATION NUMBER: REVISE trial (NCT03374800), SARS-CoV-2 cohort study (NCT05715567).

Indexed as

COVID-19PantoprazoleProton Pump InhibitorsRespiration, ArtificialAgedCOVID-19 Drug TreatmentCritical IllnessFemaleHospital MortalityHumansIntensive Care UnitsLength of StayMaleMiddle AgedSARS-CoV-2PantoprazoleProton Pump InhibitorsAdult intensive & critical careCOVID-19Research Design

Identifiers

PMID42674788
PMCPMC13536124

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.