S1345 NSAIDS and PPI Use and Its Implication on COVID-19 Patients: A Retrospective Multi-Center Study

INTRODUCTION: The effect of medications on Coronavirus disease (COVID-19) presentation, symptoms and outcomes has been a much-debated topic of discussion In this study we aim to determine if there is a relationship between the use of proton pump inhibitors (PPI) and nonsteroidal anti-inflammatory drugs (NSAIDS) on the presence of GI symptoms in COVID-19 and if there is an association of these medications with worse outcomes METHODS: This was a retrospective multicenter cohort study involving a healthcare network of 9 hospitals in the Washington D C region Patients with COVID-19 that were either evaluated in the ED or admitted to the hospital in the Medstar health system between March 8 to April 15, 2020 were recruited in this study based on ICD-10 code Manual data extraction was performed including demographics, past medical history, medication use and outcomes Unfavorable outcomes were defined as either intubation, ICU admission or death Analysis was performed using Fischer's exact tests with 2 tailed P values RESULTS: There were total of 1084 patients identified and 1079 patients included in this study GI symptoms were present in 40 6% (438 patients) of which diarrhea was the most common symptom (18 8%) followed by nausea (17 3%) and anorexia (14 7%) A total of 158 patients had active NSAIDS use and 135 had active PPI use NSAIDS use was significantly associated to the presence of GI symptoms and unfavorable outcomes (P = 0 014 and P < 0 0001, respectively) PPI use was also significantly related to the presence of GI symptoms (P = 0 031), however there was no association between PPI use and unfavorable outcomes (P = 0 16) CONCLUSION: There is a significant association of PPI use with the presence of GI symptoms among the studied inpatient cohorts, however there was no association with unfavorable outcomes NSAIDS use, on the other hand, was significantly associated with both GI symptoms and unfavorable outcomes Early reports seemed to implicate NSAIDS with poor outcome, but no concrete evidence has been published thus far Our data suggest that further analysis is required to determine the effect of NSAIDS on the COVID-19 population