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1.
Sci Rep ; 11(1): 20987, 2021 10 25.
Article in English | MEDLINE | ID: covidwho-1483149

ABSTRACT

Acid suppressants are widely-used classes of medications linked to increased risks of aerodigestive infections. Prior studies of these medications as potentially reversible risk factors for COVID-19 have been conflicting. We aimed to determine the impact of chronic acid suppression use on COVID-19 infection risk while simultaneously evaluating the influence of social determinants of health to validate known and discover novel risk factors. We assessed the association of chronic acid suppression with incident COVID-19 in a 1:1 case-control study of 900 patients tested across three academic medical centers in California, USA. Medical comorbidities and history of chronic acid suppression use were manually extracted from health records by physicians following a pre-specified protocol. Socio-behavioral factors by geomapping publicly-available data to patient zip codes were incorporated. We identified no evidence to support an association between chronic acid suppression and COVID-19 (adjusted odds ratio 1.04, 95% CI 0.92-1.17, P = 0.515). However, several medical and social features were positive (Latinx ethnicity, BMI ≥ 30, dementia, public transportation use, month of the pandemic) and negative (female sex, concurrent solid tumor, alcohol use disorder) predictors of new infection. These findings demonstrate the value of integrating publicly-available databases with medical data to identify critical features of communicable diseases.


Subject(s)
COVID-19/epidemiology , COVID-19/therapy , Gastroesophageal Reflux/complications , Social Determinants of Health , Aged , Behavior , COVID-19/psychology , California , Case-Control Studies , Computational Biology/methods , Databases, Factual , Female , Gastroenterology , Gastroesophageal Reflux/drug therapy , Geography , Histamine H2 Antagonists/pharmacology , Humans , Incidence , Male , Middle Aged , Odds Ratio , Proton Pump Inhibitors/pharmacology , Risk Factors , Social Class
2.
Drug Res (Stuttg) ; 71(6): 295-301, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1146573

ABSTRACT

BACKGROUND: COVID-19 caused by SARS-CoV-2 was declared as a global pandemic by the WHO. Famotidine is a histamine-2 (H2) receptor antagonist which blocks the H2 receptors in the parietal cells, decreasing gastric acid secretion. Our review aims to study all the available scientific evidence on famotidine research outcomes systematically to introspect its clinical efficacy and probable mechanisms and clinical efficacy against SARS-CoV-2. METHODOLOGY: An electronic search of PubMed, Scopus and Google Scholar was performed using MeSH terms "SARS CoV-2" OR "COVID-19" AND"FAMOTIDINE". Relevant informationwas extracted from studies reporting the efficacy of famotidine in COVID-19. RESULTS: We found a total of 32 studies, out of which only 14 were relevant and were included in our review.Molecular computational studies showed that famotidine selectively acts on viral replication proteases papain-like protease (PLpro) and 3-chymotrypsin-like protease (3CLpro). Additionally, it acts via inverse-agonism on the H2 receptors present in neutrophils and eosinophils which leads to inhibition of cytokine release. Clinical study findings have pointed toward significant improvements in COVID-19 patient-reported symptoms in non-hospitalized patients and reduction in intubation or death in critically ill patients associated with the usage of famotidine. However,in one of the studies,famotidine has failed to show any significant benefit in reducing mortality due to COVID-19. CONCLUSION: Famotidine has the potential to answer the ongoing global challenge owing to its selective action on viral replication. Additionally, clinical findings in COVID-19 patients support its efficacy to reduce clinical symptoms of COVID-19.We suggest that further optimally powered randomized clinical trials should be carried out to come up with definitive conclusions.


Subject(s)
COVID-19/drug therapy , Drug Repositioning , Famotidine/therapeutic use , Histamine H2 Antagonists/therapeutic use , COVID-19/immunology , COVID-19/mortality , COVID-19/virology , Cytokines/metabolism , Drug Evaluation, Preclinical , Famotidine/pharmacology , Histamine H2 Antagonists/pharmacology , Humans , Molecular Docking Simulation , Observational Studies as Topic , Pandemics/prevention & control , Patient Reported Outcome Measures , Randomized Controlled Trials as Topic , Receptors, Histamine H2/metabolism , SARS-CoV-2/drug effects , SARS-CoV-2/immunology , Signal Transduction/drug effects , Signal Transduction/immunology , Treatment Outcome , Virus Replication/drug effects
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