Abstract
Introduction: The COVID-19 pandemic has taken the lives of over 3.8 million people worldwide. Recently, multiple publications have suggested that famotidine might be effective in reducing disease severity in the inpatient and outpatient settings. Therefore, we conducted a retrospective analysis of the effects of inpatient, as well as outpatient, use of famotidine and proton pump inhibitors (PPIs) on admitted COVID-19 patients. Methods: COVID-19 positive patients >18-years-old admitted to our tertiary care center between June and August 2020 were included. Those dismissed from the ED were excluded from the study. Univariate and multivariate regression analysis was conducted to determine the effect of famotidine and PPIs on the occurrence of mortality, ICU admission and acute kidney injury (AKI). Patient age, sex, body mass index, and comorbidities (hypertension (HTN), diabetes mellitus (DM), congestive heart failure (CHF), chronic kidney disease (CKD)) were included as covariates. Odds ratios for respective variables were calculated and recorded. Results: 489 patients were included in our study. 43 patients were on PPI therapy on admission. 26 patients were on famotidine on admission. 137 were treated with famotidine while inpatient. On univariate analysis, inpatient famotidine use, age, male sex and DMwere associated with increased mortality (Figure 1Aa). Both inpatient as well as outpatient famotidine use along with male sex were associated with increased ICU admission (Figure 1Ab). Inpatient famotidine use, age, male sex, HTN, DM, CKD and CHF were associated with increased AKI (Figure 1Ac). On multivariate analysis, patient age, male sex and inpatient famotidine were associated with increased mortality (Figure 1Ba). Both inpatient and outpatient famotidine use as well as male sex were associated with increased ICU admission (Figure 1Bb). Inpatient famotidine, male sex, CKD and CHF were associated with increased AKI (Figure 1Bc). PPI use was not associated with changed outcomes in our patient population. Conclusion: While recent publications suggested that famotidine use might be effective in reducing severity of COVID-19 infection, our experience has been to the contrary. It is unclear why the use of famotidine was significantly associated with worse outcomes in our patient population. These findings are consistent with a recent study by Yeramaneni et al. (PMID: 33058865). Further studies with randomized-controlled trials are needed to better evaluate the role of famotidine in COVID-19 patients..
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