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Infectious Diseases

Updated 14 July 2020

Popular heartburn drugs may increase Covid-19 risk, new study suggests

According to new research, commonly used heartburn drugs should be added to the long list of risk factors for Covid-19.

  • Several factors, including comorbidities, can increase one's risk of Covid-19.
  • A commonly used heartburn medication, known as PPI, can affect the body's ability to fight off pathogens.
  • However, people shouldn't stop taking their medications without consulting their doctor.

As the Covid-19 pandemic progresses, we're getting to understand a bit more about the various factors that can increase your risk of severe Covid-19 infection. This includes comorbidities such as diabetes, hypertension and age.

Now, a new study published on 7 July in pre-print form in the American Journal of Gastroenterology, found in a survey of more than 86 000 people that a common heartburn drug, known as proton pump inhibitors (PPI), can increase the risk of Covid-19 infection.

From the survey, led by scientists from Cedars-Sinai Medical Centre, more than 53 000 of the 86 000 participants suffered from acid reflux, heartburn or regurgitation, and took medication for these conditions. Out of these people, more than 3 300 tested positive for Covid-19.

After analysing the data, the scientists found that those participants who used PPI to treat their conditions were two to four times more likely to test positive for Covid-19.

The drug is available over the counter and contains the ingredients lanzoprazol, pantoprazole or omeprazole (known in South Africa under the brand names Controloc, Losec, Nexiam, Pantoloc, Pariet, Lanzor and Ulzec). These drugs are usually safe, but long-term use should be monitored by a doctor, as previous research has shown that prolonged usage might increase the risk of premature death by 51%, and increase the risk of dying from heart disease, kidney failure or stomach cancer.

What is the link between the heartburn drug and Covid-19?

According to Dr Brennan Spiegel who led the research, the results aren't surprising. Not only do PPIs increase the risk of premature death, but they may also increase the risk of certain infections such as C.difficile, as these drugs reduce the amount of stomach acid which kill off pathogens such as bacteria and viruses.

The stomach and intestines play a huge role in the body's immunity, and when the gut's normal environment changes with the use of medication, for example, viruses find it easier to get a foothold.

"Viruses like SARS-CoV-2 are capable of hijacking the gastrointestinal tract quickly; we know that," says Spiegel. "They can invade, replicate and multiply efficiently. There is even a theory that maybe they use the intestines as a kind of home base to entrench themselves, and then spread throughout the body."

Significant results, but small risk

Even though Dr Spiegel found the results significant, he commented in an article published in Time that people should absolutely not stop taking their PPI medication out of fear of contracting Covid-19.

According to the research, other common heartburn drugs such as H2 blockers didn't show higher risk of Covid-19.

He also remarked that it may be possible to discuss lowering the dose with a doctor, as a lower dose may still be effective to relieve heartburn.

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