■质子泵抑制剂(PPI)的不良反应引起了广泛的关注。PPI与流感的关联尚未被探索,而肺炎或COVID-19仍然存在争议。我们的研究旨在评估使用PPI是否会增加这些呼吸道感染的风险。
■当前研究包括160,923名基线合格参与者,他们完成了药物使用问卷,其中包括PPI或组胺-2受体拮抗剂(H2RA),来自英国生物银行。Cox比例风险回归和倾向评分匹配分析用于估计风险比(HR)和95%置信区间(CI)。
■测试了与H2RA用户的比较。PPI使用与流感(HR1.32,95%CI1.12-1.56)和肺炎(风险比[HR]1.42,95%置信区间[CI]1.26-1.59)的风险增加相关。相比之下,定期使用PPI的COVID-19感染风险不显著(HR1.08,95%CI0.99-1.17),而严重COVID-19的风险(HR1.19。95%CI1.11-1.27)和死亡率(HR1.37。95%CI1.29-1.46)增加。然而,与H2RA用户相比,PPI使用者与更高的流感风险相关(HR1.74,95%CI1.19-2.54),但肺炎或COVID-19相关结局的风险并不明显.
■PPI使用者与流感风险增加有关,肺炎,以及与非使用者相比,COVID-19的严重程度和死亡率,而与使用H2RAs相比,使用PPI对肺炎或COVID-19相关结局的影响减弱。需要在综合评估的基础上适当使用PPI。
■这项工作得到了国家自然科学基金(82171698,82170561,81300279,81741067,82100238)的支持,中国高级外国专家引进计划(G2022030047L),广东省杰出青年自然科学基金(2021B1515020003),广东省基础与应用基础研究基金会(2022A1515012081),广东省科技厅外籍特聘教师项目(KD0120220129),广东省人民医院引进人才与高层次医院建设项目攀登计划(DFJH201923,DFJH201803,KJ012019099,KJ012021143,KY012021183),部分由VA临床绩效和ASGE临床研究基金(FWL)提供。
UNASSIGNED: Adverse effects of proton pump inhibitors (PPIs) have raised wide concerns. The association of PPIs with influenza is unexplored, while that with pneumonia or COVID-19 remains controversial. Our
study aims to evaluate whether PPI use increases the risks of these respiratory infections.
UNASSIGNED: The current
study included 160,923 eligible participants at baseline who completed questionnaires on medication use, which included PPI or histamine-2 receptor antagonist (H2RA), from the UK Biobank. Cox proportional hazards regression and propensity score-matching analyses were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs).
UNASSIGNED: Comparisons with H2RA users were tested. PPI use was associated with increased risks of developing influenza (HR 1.32, 95% CI 1.12-1.56) and pneumonia (hazard ratio [HR] 1.42, 95% confidence interval [CI] 1.26-1.59). In contrast, the risk of COVID-19 infection was not significant with regular PPI use (HR 1.08, 95% CI 0.99-1.17), while the risks of severe COVID-19 (HR 1.19. 95% CI 1.11-1.27) and mortality (HR 1.37. 95% CI 1.29-1.46) were increased. However, when compared with H2RA users, PPI users were associated with a higher risk of influenza (HR 1.74, 95% CI 1.19-2.54), but the risks with pneumonia or COVID-19-related outcomes were not evident.
UNASSIGNED: PPI users are associated with increased risks of influenza, pneumonia, as well as COVID-19 severity and mortality compared to non-users, while the effects on pneumonia or COVID-19-related outcomes under PPI use were attenuated when compared to the use of H2RAs. Appropriate use of PPIs based on comprehensive evaluation is required.
UNASSIGNED: This work is supported by the National Natural Science Foundation of China (82171698, 82170561, 81300279, 81741067, 82100238), the Program for High-level Foreign Expert Introduction of China (G2022030047L), the Natural Science Foundation for Distinguished Young Scholars of Guangdong Province (2021B1515020003), the Guangdong Basic and Applied Basic Research Foundation (2022A1515012081), the Foreign Distinguished Teacher Program of Guangdong Science and Technology Department (KD0120220129), the Climbing Program of Introduced Talents and High-level Hospital Construction Project of Guangdong Provincial People\'s Hospital (DFJH201923, DFJH201803, KJ012019099, KJ012021143, KY012021183), and in part by VA Clinical Merit and ASGE clinical research funds (FWL).