P3075 - The Effects of Proton Pump Inhibitor Therapy Usage and Dosing on Hospitalization Rates and Critical Care Outcomes of COVID-19 Patients

Brittney Shupp, DO¹, Sagar V. Mehta, MD², Subin Chirayath, DO³, Nishit Patel, MD⁴, Mina Aiad, DO², Jared Sapin, ³, Jill Stoltzfus, PhD¹, Yecheskel Schneider, MD^1
1St. Luke's University Health Network, Bethlehem, PA; ²St. Luke's University Hospital, Bethlehem, PA; ³St. Luke's University Health Network, Fountain Hill, PA; ⁴St. Luke's University Hospital, Easton, PA

Introduction: Proton Pump Inhibitors (PPI) are one of the most prescribed medications in the United States, but their use is associated with risk of infection due to disruption in gut flora. This has led many to question the relationship between COVID-19 and PPI use as the virus has been shown to be transmitted through both the respiratory and gastrointestinal tract. Our aim is to investigate the correlation between PPI use and COVID-19 severity.

Methods: We conducted a retrospective chart review to identify patients within our network who tested positive for SARS-CoV-2 with RT-PCR testing from March to August 2020. Patients were subdivided into groups: active, past, or no PPI use. Active users included patients prescribed PPIs within the last 30 days prior to admission. Past users included those with a history of use within the last 31 to 365 days. No PPI use included all additional patients. The strength of PPI dosing, demographic and clinical variables, comorbid conditions, and critical care outcomes were also recorded. Direct multivariable logistic regression models were created to determine primary outcomes and chi square and Kruskal Wallis tests were used in analysis of secondary outcomes.

Results: 2,594 patients met inclusion criteria (Active use, n=448 (17.3%); past use n=98 (3.8%); no use, n=2,048 (78.9%)). Majority were female (50.5%) and Caucasian (57.7%) and the mean age was 52.6 years with mean BMI of 30.7. mg/m². Subgroup analysis showed that active and past PPI users had significantly higher rates of comorbid conditions. PPI use was not associated with increased hospital admission or 30-day mortality in the regression model; however, age, male gender, diabetes, COPD, cardiovascular disease, kidney disease, and obesity were independently and significantly associated. Active PPI users had higher median length of hospital stay (p=0.02) and a higher percentage of ICU admissions (p=0.03). No secondary outcomes for active PPI users based on PPI dosage were statistically significant.

Discussion: Our results show that neither active nor past PPI use predict need for hospital admission or 30-day mortality. Admitted patients with active PPI use had higher median length of stay but higher frequency of comorbid conditions. Our data suggests descalation and discontinuation of PPI therapy when appropriate although no association was seen in our study. Ultimately in order to substantiate findings, more clinical data is necessary to determine the association between PPI use and COVID-19 susceptibility.



Disclosures:


Brittney Shupp, DO¹, Sagar V. Mehta, MD², Subin Chirayath, DO³, Nishit Patel, MD⁴, Mina Aiad, DO², Jared Sapin, ³, Jill Stoltzfus, PhD¹, Yecheskel Schneider, MD¹. P3075 - The Effects of Proton Pump Inhibitor Therapy Usage and Dosing on Hospitalization Rates and Critical Care Outcomes of COVID-19 Patients, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.