Use of Proton-Pump Inhibitor Is Not Associated with Adverse Clinical Outcomes in COVID-19 Patients: A Territory-Wide Cohort Study
Table 3
Cox proportional hazard regression on association between use of proton-pump inhibitors (PPIs) with the development of primary endpoint (a composite endpoint of intensive care unit admission, use of invasive mechanical ventilation, and death) in patients with SARS-CoV-2 infection/COVID-19 after propensity score weighting and matching.
PPI use on adverse clinical outcomes
PS weighting model
PS matching model
Main analysis
Weighted HR (95% CI)
value
Weighted HR (95% CI)
value
Composite endpoint
1.10 (0.82–1.46)
0.529
0.79 (0.56–1.13)
0.198
ICU admission
1.11 (0.79–1.57)
0.540
0.91 (0.60–1.38)
0.655
Use of invasive mechanical ventilation
0.97 (0.61–1.54)
0.882
0.66 (0.36–1.22)
0.184
Death
1.06 (0.67––1.65)
0.812
0.63 (0.35–1.13)
0.122
Subgroup analysis on current PPI user †
Weighted HR (95% CI)
value
Weighted HR (95% CI)
value
Composite endpoint
1.13 (0.82–1.55)
0.460
0.82 (0.55–1.24)
0.355
ICU admission
1.18 (0.80–1.72)
0.406
0.99 (0.60–1.62)
0.963
Use of invasive mechanical ventilation
0.98 (0.57–1.69)
0.937
0.70 (0.34–1.45)
0.335
Death
1.02 (0.61–1.70)
0.939
0.54 (0.27–1.08)
0.083
Subgroup analysis on past PPI user †
Weighted HR (95% CI)
value
Weighted HR (95% CI)
value
Composite endpoint
1.06 (0.68–1.66)
0.798
0.71 (0.38–1.31)
0.270
ICU admission
1.15 (0.70–1.89)
0.589
0.81 (0.41–1.59)
0.538
Use of invasive mechanical ventilation
1.13 (0.57–2.25)
0.726
0.73 (0.27–1.97)
0.532
Death
0.90 (0.41–1.99)
0.803
0.62 (0.18–2.10)
0.443
Sensitivity analysis ‡
Weighted HR (95% CI)
value
Weighted HR (95% CI)
value
Composite endpoint
1.11 (0.83–1.49)
0.469
0.74 (0.52–1.06)
0.099
ICU admission
1.13 (0.79–1.60)
0.502
0.86 (0.57–1.31)
0.483
Use of invasive mechanical ventilation
1.02 (0.64–1.65)
0.919
0.70 (0.38–1.30)
0.258
Death
1.09 (0.69–1.72)
0.699
0.58 (0.31–1.07)
0.082
Parameters with absolute standardised mean difference ≥0.2 were adjusted in the doubly robust model. † Current PPI user was defined as patient who had used PPI within 1 month before the diagnosis of COVID-19, while past PPI user () was defined as patient who had used PPI between 1 month and 12 months before the diagnosis of COVID-19. ‡ Short-term new nonsteroidal anti-inflammatory drug (NSAID) users who newly started NSAID within 1 month before COVID-19 diagnosis were excluded in the sensitivity analysis. CI: confidence interval; HR: hazard ratio; PPI: proton-pump inhibitor; PS: propensity score; SARS-CoV-2: severe acute respiratory syndrome coronavirus 2.
