Proton Pump Inhibitors: Current Use and the Risk of Coronavirus Infectious Disease 2019 Development and its Related Mortality. Meta-analysis

BACKGROUND: The ongoing Coronavirus Infectious Disease (COVID-19) pandemic is a global health crisis that has had a magnanimous worldwide impact on all aspects of people's lives. Several observational studies investigated the relationship between Proton Pump Inhibitors use and the risk of COVID-19 development and mortality. AIM OF THE STUDY: The aim of this meta-analysis is to investigate the association between current PPIs use and the development of COVID-19 as well as its mortality. METHODS: Pubmed, Google Scholar, ScienceDirect and medRxiv were searched until November 21, 2020 using the following keywords: proton pump inhibitors and COVID-19 as well as their related MESH terms. The studies considered in the meta-analysis were either cohort or case-control in design and adjusted for confounding factors. The quality of the studies included in this meta-analysis was assessed using the Newcastle-Ottawa Scale. In addition, a random-effects model was used to calculate the pooled Odds Ratio (ORs) and the corresponding confidence interval (95% CI). Heterogeneity was evaluated using The Cochran's Q heterogeneity test and I(2) statistic. RESULTS: Six observational studies with 195,230 participants were included. In this meta-analysis, current use of PPIs increased risk of COVID-19 development (OR = 1.19; 95% CI: 0.62-2.28) and mortality (OR = 1.67; 95% CI: 1.41-1.97). CONCLUSIONS: Our meta-analysis indicates that current PPIs use significantly increased the risk of COVID-19 mortality, but it did not reach a significant threshold in regards to the risk of COVID-19 development.