Antacids' Tenuous Link to COVID-19

On July 7, 2020, study results published in the American Journal of Gastroenterology suggest a class of drugs known as proton pump inhibitors (PPIs) could increase the risk of COVID-19. PPIs are considered the most effective medical therapy for gastroesophageal reflux disease (GERD). Common PPIs include Prilosec, Nexium, and Prevacid. GERD is one of the most common gastrointestinal disorders managed by gastroenterologists and primary care doctors with estimates of at least a quarter of the U.S. population living with the condition. Findings of the study have been highlighted in both mainstream and social media.

Misbar has discovered that it is true that researchers of the study found an association between rates of COVID-19 and taking PPIs daily. The basis for the findings was an emailed survey completed by over 86,000 people, with 61 percent reporting having acid reflux and similar symptoms. Among the respondents, 6.4% reported having a positive COVID-19 test.

However, this study has several limitations that should require more research before any associations are broadly advertised. First, the data was collected by people filling out information without any one checking for accuracy. In other words, did the participants really have a confirmed COVID-19 test result or did they just suspect they had the disease? Also, this was not a study of the general, and probably healthier, population. It was a study of individuals with prior abdominal pain or discomfort. It has been shown that people with underlying health conditions are more at risk when it comes to COVID-19.

Also, COVID-19 commonly leads to abdominal symptoms, so it is possible that those who responded already had the disease and were treating their condition with PPIs. In the study, 96% of those who tested positive for Covid-19 reported they were symptomatic. According to the CDC, the current rate of those with COVID-19 who have symptoms is about 60%. Those who took time to complete the survey were possibly at home and not feeling well, while those who were taking PPIs without COVID-19 were potentially too busy to complete the survey. 61% of people who responded reported acid reflux which is also well above the known rates of the condition, potentially demonstrating the imbalance of the responses.

The problem with claiming an association this early on in the research is the risk of people fearing COVID-19 and discontinuing their acid reflux medication. Untreated GERD can be extremely dangerous leading to esophageal bleeding, ulcers, and an increased risk of a very aggressive cancer. A previous study showing an association between PPIs and dementia did not stand up over time.