Recently there have been many concerns regarding the use of acid
suppression therapy in the setting of the COVID-19 pandemic. We review
here the biological plausibility, the evidence and the recommendations
for acid suppressant use in the present COVID-19 pandemic. After
adjusting for confounding factors, PPI use, especially twice-daily
dosing, seem to be associated with acquiring COVID-19 infection and
worse outcomes among patients with COVID-19, compared to non-users. PPI
induced hypochlorhydria may be responsible for the observed effects.
Famotidine seems to protect against clinical deterioration among
hospitalised and improves patient-reported outcomes among
non-hospitalised patients with COVID-19, compared to non-users.
Famotidine interfering maturation of SARS-CoV-2 and reducing
inflammation may be responsible for the observed effect. The knowledge
from the recent studies could help by reminding PPI users to be
especially vigilant about following protective health behaviours and
should also encourage physicians to prescribe PPIs rationally during and
after the pandemic.