Use of Proton-Pump Inhibitor Is Not Associated with Adverse Clinical Outcomes in COVID-19 Patients: A Territory-Wide Cohort Study
Table 4
Univariate and multivariable analyses with Cox proportional hazards regression on factors associated 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 multiple imputation and before propensity score balancing.
Parameters
Univariate analysis
Multivariable analysis
HR (95% CI)
value
aHR (95% CI)
value
PPI use
3.36 (2.71–4.18)
<0.001
0.84 (0.67–1.06)
0.142
H2RA use
2.61 (2.14–3.19)
<0.001
NSAID use
1.32 (1.00–1.73)
0.049
Aspirin use
4.35 (3.48–5.43)
<0.001
Age (years)
1.07 (1.06–1.07)
<0.001
1.03 (1.02–1.04)
<0.001
Male gender
1.76 (1.47––2.11)
<0.001
1.29 (1.07–1.56)
0.009
Circulatory system disease
8.33 (6.83–10.16)
<0.001
1.38 (1.08–1.76)
0.009
Digestive system disease
2.90 (2.36–3.55)
<0.001
Diabetes mellitus
12.84 (10.61–15.53)
<0.001
3.58 (2.87–4.46)
<0.001
Malignant tumour
3.50 (2.61–4.68)
<0.001
Nervous system disease
3.77 (2.92–4.88)
<0.001
Respiratory disease
5.60 (4.43––7.07)
<0.001
2.21 (1.73–2.82)
<0.001
Chronic kidney disease
7.55 (5.74–9.93)
<0.001
1.37 (1.03––1.84)
0.031
Creatinine
1.003 (1.002–1.003)
<0.001
Albumin
0.86 (0.85–0.87)
<0.001
0.98 (0.96–0.99)
0.007
Alanine aminotransferase
1.001 (1.001–1.002)
<0.001
1.001 (1.000–1.002)
0.001
Total bilirubin
1.02 (1.01–1.02)
<0.001
LDH
1.006 (1.006–1.006)
<0.001
1.004 (1.003–1.004)
<0.001
C-reactive protein
1.16 (1.15–1.17)
<0.001
1.06 (1.05–1.08)
<0.001
Haemoglobin
0.84 (0.80–0.89)
<0.001
Neutrophil to lymphocyte ratio
1.08 (1.07–1.08)
<0.001
Platelet
0.993 (0.991–0.994)
<0.001
0.997 (0.995–0.998)
<0.001
SpO2
0.95 (0.94–0.96)
<0.001
Respiratory rate
1.03 (1.02–1.04)
<0.001
1.02 (1.01–1.04)
0.010
PPI, H2RA, NSAID, and aspirin user referred to PPI, H2RA, NSAID, and aspirin use within 12 months before the diagnosis of COVID-19. Patients were followed from the date of COVID-19 diagnosis to the date of discharge, the last follow-up date (1 January 2021), date of intensive care unit admission, date of use of invasive mechanical ventilation, or date of death, whichever came first. aHR: adjusted hazard ratio; CI: confidence interval; H2RA: H2 receptor antagonist; LDH: lactate dehydrogenase; NSAID: nonsteroidal anti-inflammatory drug; PPI: proton-pump inhibitor; SARS-CoV-2: severe acute respiratory syndrome coronavirus 2; SpO2: peripheral oxygen saturation.
