THREAD: More data about PPIs and SARS-CoV-2 coming out. Is there a consistent association across studies? @statsepi @DrToddLee @supermarioelia @mikejohansenmd @ADAlthousePhD Increased prevalence of ARDS in those taking PPI at baseline: onlinelibrary.wiley.com/doi/full/10.11…
prior use of PPIs associated with higher rate of death in COVID-19 infected patients. medrxiv.org/content/10.110…
Severe COVID-19 outcomes in Korea associated with PPI use gut.bmj.com/content/gutjnl…
Higher mortality from COVID-19 in prior PPI users medrxiv.org/content/10.110…
PPIs(along with anti-psychotics, opioids, and polypharmacy) associated with severe COVID-19 in Scotland. medrxiv.org/content/10.110…
While there were some weird demographic shifts in the original B. Spiegel study, the PPI finding appears to be holding up. I will continue to be spooked about internet surveys with incentives, & how they can be gamed, but repeated studies with different methods in diff.settings..
are backing up the association between pre-hospitalization PPI use (often with weak indications) and more severe COVID-19 cases. The great thing about medial science is that lots of people can do it, and many people are ready to challenge or refute your findings...
But in this case the primary finding seems to be holding up - PPI use prior to hospitalization (and likely prior to infection) is associated with worse outcomes in COVID-19. Nice to see a scientific hypothesis stress-tested across multiple countries and hold up. Science.

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More from @ibddoctor

14 Jul
@MaartenvSmeden @AllonKahn @georgemsavva @IBDMD @ADAlthousePhD @doctorira @tmorris_mrc @BrennanSpiegel @NYUDocs @statsepi There is some very weird stuff going on in this sample (as pointed out in the open letter), and given the high response rate to an online survey, lots of hard questions need to be asked of CINT (the survey company) about how they get respondents.
@MaartenvSmeden @AllonKahn @georgemsavva @IBDMD @ADAlthousePhD @doctorira @tmorris_mrc @BrennanSpiegel @NYUDocs @statsepi I worry about the data source more than the analysis (though people certainly can make coding/labeling errors, and data/code repositories and code review are helpful). I can imagine a lower rate of respondents >60yo in an online survey. And maybe low rate of GERD depending...
@MaartenvSmeden @AllonKahn @georgemsavva @IBDMD @ADAlthousePhD @doctorira @tmorris_mrc @BrennanSpiegel @NYUDocs @statsepi On how the question is asked. Asking about "heartburn" tends to be a lot more sensitive than asking about GERD (jargon). But ~16x lower vs a comparable sample seems too much. The gender ratio is odd, but odd things happen. But when you get to the high RR for SARS-CoV-2 in 30-39..
Read 9 tweets
29 Apr
This Saturday, May 2nd, will be a little sad for me. I (and about 13,000 of my GI friends) would have been in Chicago for @DDWMeeting. That won't happen. So I decided (with a few friends) to have a get-together. A #TotallyUnofficial "Poster Rounds".
In a webinar format over 1 hour, at 3PM EDT, noon PDT, 8 PM UK time, 9 PM CET, with informal presentations and discussion of 4 posters. We will have two posters that would have been presented at the meeting, and two "late breakers"/works in progress.
Our new IMIBD section vice chair, Fernando Velayos @Realcecum and I will host. @charlie_lees will lead off with a presentation of his new study of #IBD telemedicine across countries, a topic we have all had to become familiar with very rapidly in the Time of #COVID19
Read 8 tweets
25 Feb
Questions today about the risk of coronavirus nCoV-19 in #IBD patients on immunosuppressive therapies. We don't know a lot, as this is quite new. The most up-to-date information can be found at the CDC website cdc.gov/coronavirus/20…
It appears to be spread by respiratory droplets, generally when you inhale droplets from a cough or sneeze from a nearby person (usually within 6 feet). Do #IBD patients have increased risk for this respiratory virus?
By analogy to influenza, another respiratory virus spread by droplets that we know more about, #IBD patients have about a 50% increased risk of influenza. This risk goes up by about 20% more if you are on steroids. ncbi.nlm.nih.gov/pubmed/30020478
Read 8 tweets

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