Association between PPIs and COVID-19

Omeprazole is a proton pump inhibitor (PPI). Omeprazole is a medicine used to treat gastroesophageal reflux disease (GERD), peptic ulcer disease, and Zollinger-Ellison syndrome. It is marketed under the trade names Prilosec, Losec, among others. Additionally, it is applied to high-risk individuals to stop upper gastrointestinal bleeding.

A novel coronavirus, the severe acute respiratory syndrome coronavirus 2, is the cause of COVID-19, a respiratory illness that affects people worldwide (SARS-CoV-2). The World Health Organisation labelled it a pandemic on March 11, 2020, after the first report of it came in December 2019 from Wuhan, China. Animals and humans can contract the single-stranded positive-sense RNA virus family known as coronaviruses. They are the beta-coronavirus, gamma-coronavirus, delta-coronavirus, and alpha-coronavirus.

Common symptoms of COVID-19 include fever, coughing, and exhaustion.

GERD, non-erosive reflux disease, and peptic ulcer disease are the most common upper gastrointestinal acid-related illnesses for which proton pump inhibitors (PPI) are typically prescribed over-the-counter. PPI are typically prescribed at higher doses for longer periods of time because of their high efficacy, attractive safety profile, and affordability for treating problems of the upper GI tract. In fact, up to 70% of the time, PPI are prescribed without a clear indication, making them one of the ten most often used medications worldwide. PPI can have a deleterious impact on a number of bodily organ systems. PPI has been linked, for instance, to an increased risk of developing chronic kidney disease, which can advance to end-stage renal disease and pneumonia because of PPI-induced hypochloremia.

In the early stages of the COVID-19 pandemic, medical professionals in Wuhan made a surprising observation. Poor elderly patients made up a large portion of those who survived the infection; they are not the type of people you would typically anticipate to do well in a health emergency.

Many of the survivors had persistent heartburn and were using the cheap medication Omeprazole, it was discovered after an examination of their medical records. According to Xiang Y, PPI reduces one's vulnerability to COVID-19. Ramchandran also noted a rise in mortality when PPIs were used. 

Almario did note, however, that PPI administration increased the risk of contracting COVID-19 infection. According to a large national health survey carried out in the United States, using PPIs increases the likelihood of reporting a positive COVID-19 test. The researchers observed a significant prevalence of GI symptoms and found that the virus sheds into saliva before being ingested by the stomach. When the analysis was done, it was found that there was a dose-response connection, with patients taking PPIs twice daily having significantly higher odds of testing positive for COVID-19 than those taking PPIs at lower doses up to once daily.

In contrast to all of the others, Fan X did not discover a link between PPI and COVID-19 infection-related death. Regarding the relationship between proton pump inhibitors (PPI), like Omeprazole, and the likelihood of contracting and the severity of SARS-CoV-2 infection, there is conflicting information.

The significance of customised, evidence-based therapy is stressed due to the lack of general agreement regarding the effects of PPIs, such as Omeprazole, in COVID-19 patients. PPI use in individuals with COVID-19 requires healthcare professionals to balance the dangers vs the benefits.