Proton pump inhibitors and the risk of severe COVID-19: a post-hoc analysis from the Korean nationwide cohort

Lee, Seung Won; Yang, Jae‐Ho; Yoo, In Kyung; Moon, Sung Yong; Ha, Eun Kyo; Yeniova, Abdullah Özgür; Cho, Joo Young; Kim, Min Seo; Shin, Jae Il; Yon, Dong Keon

doi:10.1136/gutjnl-2020-323672

Cited by 52 publications

(52 citation statements)

References 9 publications

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“…24 25 Ratings of 4.0 and 8.0 METs were assigned for moderate and vigorous intensity activity, respectively. 24 25 The level of physical activity was categorised into four: (1) 3) active (500-<1000 MET min/week) and (4) highly active (more than 1000 MET min/week).…”

Section: Exposures and Outcomesmentioning

confidence: 99%

“…The COVID-19 caused by the novel SARS-CoV-2 has spread rapidly across the globe. [1][2][3] Despite dedicated efforts to end the pandemic including vaccination and antiviral therapies based on blood products and antibody, the emergence of more than 5000 mutations and the continued second or more waves of infection have made the prevailing situation extremely complicated. 4 Baseline characteristics of patients, including old age, obesity, heavy smoking status and underlying comorbidities, such as hypertension, respiratory disease, cardiovascular disease and cancer have been shown to be associated with increased risk of COVID-19 and COVID-19 related death.…”

Section: Introductionmentioning

confidence: 99%

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Physical activity and the risk of SARS-CoV-2 infection, severe COVID-19 illness and COVID-19 related mortality in South Korea: a nationwide cohort study

et al. 2021

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PurposeTo determine the potential associations between physical activity and risk of SARS-CoV-2 infection, severe illness from COVID-19 and COVID-19 related death using a nationwide cohort from South Korea.MethodsData regarding 212 768 Korean adults (age ≥20 years), who tested for SARS-CoV-2, from 1 January 2020 to 30 May 2020, were obtained from the National Health Insurance Service of South Korea and further linked with the national general health examination from 1 January 2018 to 31 December 2019 to assess physical activity levels. SARS-CoV-2 positivity, severe COVID-19 illness and COVID-19 related death were the main outcomes. The observation period was between 1 January 2020 and 31 July 2020.ResultsOut of 76 395 participants who completed the general health examination and were tested for SARS-CoV-2, 2295 (3.0%) were positive for SARS-CoV-2, 446 (0.58%) had severe illness from COVID-19 and 45 (0.059%) died from COVID-19. Adults who engaged in both aerobic and muscle strengthening activities according to the 2018 physical activity guidelines had a lower risk of SARS-CoV-2 infection (2.6% vs 3.1%; adjusted relative risk (aRR), 0.85; 95% CI 0.72 to 0.96), severe COVID-19 illness (0.35% vs 0.66%; aRR 0.42; 95% CI 0.19 to 0.91) and COVID-19 related death (0.02% vs 0.08%; aRR 0.24; 95% CI 0.05 to 0.99) than those who engaged in insufficient aerobic and muscle strengthening activities. Furthermore, the recommended range of metabolic equivalent task (MET; 500–1000 MET min/week) was associated with the maximum beneficial effect size for reduced risk of SARS-CoV-2 infection (aRR 0.78; 95% CI 0.66 to 0.92), severe COVID-19 illness (aRR 0.62; 95% CI 0.43 to 0.90) and COVID-19 related death (aRR 0.17; 95% CI 0.07 to 0.98). Similar patterns of association were observed in different sensitivity analyses.ConclusionAdults who engaged in the recommended levels of physical activity were associated with a decreased likelihood of SARS-CoV-2 infection, severe COVID-19 illness and COVID-19 related death. Our findings suggest that engaging in physical activity has substantial public health value and demonstrates potential benefits to combat COVID-19.

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Section: Exposures and Outcomesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Physical activity and the risk of SARS-CoV-2 infection, severe COVID-19 illness and COVID-19 related mortality in South Korea: a nationwide cohort study

et al. 2021

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“…SJU-HR-E-2020-012). 13 The requirement for written consent was waived by the ethics committee due to urgent medical needs during the COVID-19 pandemic. This study adhered to the tenets of the Declaration of Helsinki.…”

Section: Methodsmentioning

confidence: 99%

COVID-19 Morbidity and Severity in Patients With Age-Related Macular Degeneration: A Korean Nationwide Cohort Study

Yang

Moon

Lee

et al. 2022

American Journal of Ophthalmology

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Objective To determine the potential association of age-related macular degeneration (AMD), a representative chronic age-related degenerative disease of the retina associated with inflammation and aging, with susceptibility to SARS-CoV-2 infection and severe COVID-19 outcomes. Design Nationwide cohort study with propensity-score matching. Setting Population-based nationwide cohort in Korea. Study population Data were obtained from the Health Insurance Review & Assessment Service of Korea, including all patients older than 40 years who underwent SARS-CoV-2 testing in South Korea between January 1, 2020, and May 15, 2020 (excluding self-referral). Main outcome measures SARS-CoV-2 test positivity was the primary outcome and severe clinical outcome of COVID-19 was the secondary outcome. Results The unmatched cohort consisted of 135,435 patients who were tested for SARS-CoV-2; 4531 (3.3%) tested positive for SARS-CoV-2; 5493 (4.1%) patients had AMD. After propensity score matching, exudative AMD was associated with an increased likelihood of susceptibility to SARS-CoV-2 infection (adjusted odds ratio [aOR], 1.50; 95% confidence interval [CI], 1.03-2.25), and a considerably greater risk of severe clinical outcomes of COVID-19 (aOR, 2.26; 95% CI, 1.02 to 5.26), but not any AMD and non-exudative AMD. Conclusions In a Korean nationwide cohort, our data suggest that clinicians should be aware of the greater risk of susceptibility to severe clinical outcomes of COVID-19 in patients with exudative AMD. Our findings provide an improved understanding of the relationship between the pathogenesis of COVID-19 and chronic neurological disorders.

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“…There are now multiple studies showing that the use of proton pump inhibitors (PPIs) is associated with worse outcomes in COVID-19 [50,51]. There is more than one interpretation of this observation.…”

Section: The Role Of the Stomach In Mitigating Covid-19mentioning

confidence: 99%

Perspective: the nose and the stomach play a critical role in the NZACE2-Pātari* (modified ACE2) drug treatment project of SARS-CoV-2 infection

Ameratunga

Woon

Steele

et al. 2021

Expert Review of Clinical Immunology

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Background: COVID-19 has caused calamitous health, economic and societal consequences globally. Currently, there is no effective treatment for the infection. Areas covered: We have recently described the NZACE2-Pātari project, which seeks to administer modified Angiotensin Converting Enzyme 2 (ACE2) molecules early in the infection to intercept and block SARS-CoV-2 binding to the pulmonary epithelium. Expert opinion: Since the nasopharyngeal mucosa is infected in the first asymptomatic phase of the infection, treatment of the nose is likely to be safe and potentially effective. The intercepted virus will be swallowed and destroyed in the stomach. There is however a limited window of opportunity to alter the trajectory of the infection in an individual patient, which requires access to rapid testing for SARS-CoV-2. The proposed strategy is analogous to passive immunization of viral infections such as measles and may be of particular benefit to immunodeficient and unvaccinated individuals.

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Proton pump inhibitors and the risk of severe COVID-19: a post-hoc analysis from the Korean nationwide cohort

Cited by 52 publications

References 9 publications

Physical activity and the risk of SARS-CoV-2 infection, severe COVID-19 illness and COVID-19 related mortality in South Korea: a nationwide cohort study

Physical activity and the risk of SARS-CoV-2 infection, severe COVID-19 illness and COVID-19 related mortality in South Korea: a nationwide cohort study

COVID-19 Morbidity and Severity in Patients With Age-Related Macular Degeneration: A Korean Nationwide Cohort Study

Perspective: the nose and the stomach play a critical role in the NZACE2-Pātari* (modified ACE2) drug treatment project of SARS-CoV-2 infection

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