JGH Open (Jul 2023)

A retrospective analysis of clinical outcomes between hospitalized patients with COVID‐19 who received famotidine or pantoprazole

  • Justin J. Wagner,
  • Nikolas St. Cyr,
  • Aaron Douen,
  • Joshua Fogel,
  • John Trillo

DOI
https://doi.org/10.1002/jgh3.12905
Journal volume & issue
Vol. 7, no. 7
pp. 464 – 469

Abstract

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Abstract Background and Aim There is limited research on the use of histamine‐H2 receptor antagonists and proton pump inhibitors for treating COVID‐19. We compare clinical outcomes between patients hospitalized with COVID‐19 receiving famotidine or pantoprazole. Methods This retrospective study included 2184 patients (famotidine: n = 638, pantoprazole: n = 727, nonuse: n = 819) aged 18 years or older treated for COVID‐19 from March 2020 to March 2021. Patients who received both famotidine and pantoprazole treatments were excluded. Multivariate logistic regression was used for the primary outcome, namely all‐cause mortality, and the secondary outcomes, namely mechanical ventilation, vasopressor use, acute kidney injury, and gastrointestinal bleeding. The main predictor variable was the use of famotidine or pantoprazole. Covariates were demographics, chronic diseases, and symptoms. Results As compared to nonuse, famotidine (OR: 0.30, 95% CI: 0.20–0.44, P < 0.001) and pantoprazole (OR: 0.47, 95% CI: 0.33–0.66, P < 0.001) were significantly associated with lower odds for all‐cause mortality. Comparison of famotidine and pantoprazole showed that the former had lower odds for all‐cause mortality (OR: 0.65, 95% CI:0.45–0.95, P < 0.05), mechanical ventilation (OR: 0.38, 95% CI: 0.25–0.58, P < 0.001), vasopressor use (OR: 0.33, 95% CI: 0.22–0.48, P < 0.001), acute kidney injury (OR: 0.40, 95% CI: 0.30–0.54, P < 0.001), and gastrointestinal bleeding (OR: 0.15, 95% CI: 0.08, 0.29, P < 0.001). Conclusions Famotidine is associated with lower odds for all‐cause mortality, mechanical ventilation, vasopressor use, acute kidney injury, and gastrointestinal bleeding as compared to pantoprazole in patients hospitalized with COVID‐19. We recommend that clinicians consider the use of famotidine over pantoprazole for hospitalized COVID‐19 patients. Future research with a clinical trial would be beneficial to further support such use of famotidine.

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