ABSTRACT
IntroductionFamotidine is a competitive histamine H2-receptor antagonist most commonly used for gastric acid suppression but thought to have potential efficacy in treating patients with COVID-19. The aims of this systematic review and meta-analysis are to summarize the current literature and report clinical outcomes on the use of famotidine for treatment of hospitalized patients with COVID-19. MethodsFive databases were searched through February 12, 2021 to identify observational studies that reported on associations of famotidine use with outcomes in COVID-19. Meta-analysis was conducted for composite primary clinical outcome (e.g. rate of death, intubation, or intensive care unit admissions) and death separately, where either aggregate odds ratio (OR) or hazard ratio (HR) was calculated. ResultsFour studies, reporting on 46,435 total patients and 3,110 patients treated with famotidine, were included in this meta-analysis. There was no significant association between famotidine use and composite outcomes in patients with COVID-19: HR 0.63 (95% CI: 0.35, 1.16). Across the three studies that reported mortality separated from other endpoints, there was no association between famotidine use during hospitalization and risk of death - HR 0.67 (95% CI: 0.26, 1.73) and OR 0.79 (95% CI: 0.19, 3.34). Heterogeneity ranged from 83.69% to 88.07%. ConclusionBased on the existing observational studies, famotidine use is not associated with a reduced risk of mortality or combined outcome of mortality, intubation, and/or intensive care services in hospitalized individuals with COVID-19, though heterogeneity was high, and point estimates suggested a possible protective effect for the composite outcome that may not have been observed due to lack of power. Further RCTs may help determine the efficacy and safety of famotidine as a treatment for COVID-19 patients in various care settings of the disease.
ABSTRACT
ObjectiveTo examine associations between sociodemographic and mental health characteristics with household food insecurity as a result of the COVID-19 outbreak. DesignCross-sectional online survey analyzed using univariable tests and a multivariable logistic regression model. SettingThe United States during the week of March 30, 2020. ParticipantsConvenience sample of 1,965 American adults using Amazons Mechanical Turk (MTurk) platform. Participants reporting household food insecurity prior to the pandemic were excluded from analyses. Results1,517 participants reported household food security before the COVID-19 outbreak. Among this subset, 30% reported food insecurity after the COVID-19 outbreak, 53% were women and 72% were white. On multivariable analysis, race, income, relationship status, anxiety, and depression were significantly associated with incident household food insecurity. Black respondents, Hispanic/Latino respondents, and respondents with annual income less than $100,000 were significantly more likely to experience incident household food insecurity. Individuals experiencing incident household food insecurity were 2.09 (95% CI 1.58-2.83) times more likely to screen positively for anxiety and 1.88 (95% CI 1.37-2.52) times more likely to screen positively for depression. ConclusionsFood insecurity due to the COVID-19 pandemic is common, and certain populations are particularly vulnerable. There are strong associations between food insecurity and anxiety/depression. Public health interventions to increase the accessibility of healthful foods, especially for Black and Hispanic/Latino communities, are crucial to relieving the economic stress of this pandemic.
