S1326 Effect of Gastric Acid Suppression in Gastrointestinal Manifestations of COVID-19

INTRODUCTION: The pandemic caused by the Coronavirus Disease 2019 (COVID-19) has led to over 5 million cases and 340,000 deaths globally as of May 2020 There are increasing reports of gastrointestinal symptoms including diarrhea, nausea, and abdominal pain suggestive of gastrointestinal infection by COVID-19 In vitro studies developed for the safe handling of the COVID-19 virus have reported inactivation of coronavirus in highly acidic conditions (pH < 3) such as the human stomach which has a pH range between 1 0 to 3 5 Proton pump inhibitor (PPI) and H2 receptor blocker (H2B) medications are ubiquitous in clinical practice and have been shown to be highly effective in raising intragastric pH We hypothesize that acid-suppressing medications taken prior to COVID-19 infection lead to increased gastrointestinal symptoms due to altered gastric pH potentially influencing viral load METHODS: This was a single center retrospective cohort study Adult patients with confirmed COVID-19 infection admitted from March to April 2020 were identified and charts were reviewed for patient demographics, outpatient medication list, symptoms associated with COVID-19 infection, and hospital course The primary outcome was prevalence of gastrointestinal symptoms (abdominal pain, nausea, diarrhea) between the acid-suppressed patients and non-acid-suppressed patients Secondary outcomes compared need for intensive care, length of stay, and mortality RESULTS: We reviewed 100 consecutive patients admitted with COVID-19 Twenty-four patients were taking acid-reducing medications prior to admission There were more females in the acidsuppressed group (41 7%) compared to the non-acid-suppressed group (34 2%) and average age was approximately 59 years for both (Table 1) Overall, GI symptoms occurred in 33 3% of acidsuppressed patients and 34 2% of the non-acid suppressed patients (P = 0 937) (Figure 1) No significant differences in specific GI symptoms were observed between the groups Need for intensive care, length of stay, and mortality did not differ (Table 1) CONCLUSION: While in vitro studies suggest a potential deleterious effect for patients taking acidsuppressive medications prior to COVID-19 infections, no association was noted in gastrointestinal symptoms, acuity of care, length of stay, or mortality in patients taking PPI or H2 blocker medications prior to admission for COVID-19 infection in our cohort (Figure Presented)