Some Stomach Drugs Increase COVID Susceptibility

Some Stomach Drugs Increase COVID Susceptibility
Christopher Almario, MD, Cedars-Sinai Medical Center, Los Angeles, lead author

Doctors at UCLA and University of Michigan affiliated hospitals have found that daily use of a PPI (Proton Pump Inhibitor) type acid reducer more than doubles COVID susceptibility, and that taking these medications twice a day can increase susceptibility to COVID by a factor of 3.7 (a 270% increase).  Medications we should avoid taking during the COVID epidemic include:

AVOID

  • omeprazole (Prilosec, Prilosec OTC, Zegerid)
  • lansoprazole (Prevacid)
  • pantoprazole (Protonix)
  • rabeprazole (Aciphex)
  • esomeprazole (Nexium, Vimovo)
  • dexlansoprazole (Dexilant)

Another type of acid reducer, H2 blockers, do not increase COVID-19 susceptibility.  These include:

OK

  • cimetidine (Tagamet)
  • nizatidine (Axid)
  • famotidine (Pepcid)

Recognizing the importance of the Almario study's finding, the American College of Gastroenterology (ACG) issued a letter discussing the study's limitations and cautioning against drawing hasty conclusions.  Nevertheless, the finding is dramatic, and the ACG does not downplay it.

If PPI's were drugs in clinical trials as opposed to FDA approved over-the-counter medicines, findings like those of Dr. Almario and his coauthors would cause ethics advisors to halt the trial.  But PPIs are widely used drugs sold without a doctor's prescription, in many cases.

When President Trump suggested injecting disinfectant, most doctors were quick to say no form of that is a good idea.  One reason: to the extent it is a good idea, our bodies already do it.  Stomach acids, created by our "gastric proton pumps," are one mechanism.  Disable that mechanism in such a way that the pH of the stomach is no longer below 3 and the stomach loses its ability to kill the coronavirus, allowing it to infect cells in the intestine.

As of July 25, 2020 there have been 4,024,492 confirmed cases of COVID in the United States, and 143,868 deaths.  Drugwatch.com estimates the number of Americans routinely taking PPIs at 15,000,000.  The population of the United States is currently 330,000,000 according to the Census Bureau Population Clock.  If Doctors Almario, Chey, and Spiegel are correct, one can use these numbers to work out that there have probably been over 9,000 deaths in the U.S. due to PPI use.

While the conditions gastroenterologists treat with PPI medications are real, increasing understanding of the microbiome that is the stomach and digestive system makes treatment alternatives available.  Old fasioned treatments sometimes work, too.  That being the case, the FDA has options including repeal of approval of PPI drugs for over-the-counter sale and other actions to warn the public of the risk PPIs pose during this pandemic.