Case–control study of the association of chronic acid suppression and social determinants of health with COVID-19 infection

• Published in: Scientific reports Vol. 11; no. 1; p. 20987
• Main Authors: Zhang, Bing, Silverman, Anna L., Bangaru, Saroja, Arneson, Douglas, Dasharathy, Sonya, Nguyen, Nghia, Rodden, Diane, Shih, Jonathan, Butte, Atul J., El-Nachef, Wael Noor, Boland, Brigid S., Rudrapatna, Vivek Ashok
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 25-10-2021; Nature Publishing Group; Nature Portfolio
• Subjects: 631/114; 692/308; 692/4020; 692/699; 692/700; Acids; Aged; Antacids; Behavior; California; Case studies; Case-Control Studies; Chronic infection; Computational Biology - methods; Coronaviruses; COVID-19; COVID-19 - epidemiology; COVID-19 - psychology; COVID-19 - therapy; Databases, Factual; Dementia disorders; Female; Gastroenterology; Gastroesophageal Reflux - complications; Gastroesophageal Reflux - drug therapy; Geography; Health risks; Histamine H2 Antagonists - pharmacology; Humanities and Social Sciences; Humans; Incidence; Infections; Male; Middle Aged; multidisciplinary; Odds Ratio; Pandemics; Patients; Proton Pump Inhibitors - pharmacology; Public transportation; Risk Factors; Science; Science (multidisciplinary); Social Class; Social Determinants of Health; Solid tumors; California
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-021-00367-7

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.