Hopefully mostly anxiety, but you know…
April 24, 2022 10:41 PM   Subscribe

Does anyone know whether PPIs actually do meaningfully affect COVID outcomes, and if yes, stopping them after catching it will help?

Asking for a me. I’m on a prescribed 4 week course of PPIs for a very bad bout of acid reflux I was having recently. Yesterday, I tested positive for COVID. I have a mild fever and the usual symptoms, feel pretty crappy but mostly like a bad cold so far.

I randomly remembered that in the past when on PPIs I tend to be more susceptible to infection, so I looked up whether they can affect COVID infection/outcomes. And… maybe? I wrote a note to my doctor through the medical app and she said the data did not look significant, but I’m still pretty scared I’m setting myself up for a secondary infection/pneumonia by continuing to take them while I have COVID. (I also don’t know if stopping them now will make any difference since from my understanding the pumps in your stomach need to regenerate, or something).

Honestly, I’m pretty sad/scared at the moment so if you had COVID while on PPIs I wouldn’t mind hearing your experience— also would very much like to hear from anyone capable of interpreting the existing data. Thank you!
posted by stoneandstar to Health & Fitness (8 answers total) 2 users marked this as a favorite
Best answer: I'm not particularly knowledgeable about these things, but I've had Covid while on PPI. Don't know if this will help you decide what is best for you, but something that is important about taking PPIs that your doctor may not have told you is that it's a bad idea to stop abruptly.
It's important to wean yourself gradually otherwise you can have unpleasant rebound symptoms as your system reassert itself.
So whatever you do, don't just stop cold.
If I were you, I'd concentrate more of my efforts on finding ways to manage my anxiety.
It's OK to have these doubts and fears, but they don't have to dominate your life.
In my own case, taking a PPI did not affect me badly despite my system being low. In my case, my anxiety messed up my digestive system and caused gastritis.
The things that helped me much more than PPIs were therapy and medication to deal with my anxiety (an SSRI)
But of course your case might be very different.
Sending you kind, healing thoughts and hope you can find ease in this confusing, stressful time.
posted by Zumbador at 11:12 PM on April 24, 2022 [4 favorites]

Best answer: You may feel encouraged by this more recent study:

Conclusion: PPIs are spuriously associated with severe COVID-19 due to the presence of elevated FBG [fasting blood glucose] as a confounder. Our study accounted for the FBG levels of patients and known risk factors for severe COVID-19 infection, which may be the reason for the discrepancy in prior studies. These results may aid in understanding potential confounders when evaluating potential associations of PPIs with other respiratory or viral diseases.


(Sorry, embedded links not working from my phone this morning)
posted by blue suede stockings at 5:33 AM on April 25, 2022 [3 favorites]

I am currently on PPI's for esophagitis. I have been experiencing intermittent anxiety, so I googled to see if it could be related to the PPI's. One google result is, "People taking a PPI were about twice as likely as other individuals to report depression or anxiety." I think that not feeling well in itself can bring on anxiety, and then adding a PPI on top of that could, I assume, bring on even more anxiety. So when I'm feeling anxiety, I tell myself that it is just my esophagitis and PPI talking, and this helps me calm down.

Also, what I found upon my googling quest is that PPI's don't increase the risk of infection in general. Instead, they increase the risk of enteric infection (ie, microbial infections like botulism, salmonella, etc.) - you know, infections of your gut. Based on this, PPI's wouldn't increase risk of infection for things like covid.

And, yes, when going off PPI's it is best to taper gradually. The following is from a doctor I encountered on my google search: "For example, if someone is on 20 mg of omeprazole twice daily, I will reduce the dose to 20 mg once daily for 10 days and then 20 mg every other day for 10 days before stopping."

It is stressful to be sick, but it sounds like you are hanging in there. I hope you feel better soon!
posted by SageTrail at 5:36 AM on April 25, 2022 [4 favorites]

If you haven't, since it looks like you're in the US, you are most likely eligible to access Paxlovid, which can drastically reduce your risk of COVID complications while on PPIs. Where I live, that's as easy as going to the CVS up the street, getting tested, and walking out with a prescription.
posted by hydropsyche at 7:13 AM on April 25, 2022 [3 favorites]

Best answer: I had covid at the end of January, and kept taking a PPI all through it. I was triple-vaxxed at the time I tested positive, which may have contributed to the outcome - but for me it was just like a moderate cold, with slightly less nasal congestion and slightly more sore throat and fever (more than no fever, basically) than I'm used to when I catch a cold. I haven't had any significant post-covid issues, though the brain fog did last for about two-three weeks after I stopped testing positive.
posted by invincible summer at 2:13 PM on April 25, 2022

Response by poster: Hydropsyche, how does one go about getting Paxlovid? I am early thirties with no serious health conditions, not sure I qualify.
posted by stoneandstar at 4:47 PM on April 25, 2022

Literally just follow the link, and locate a site. In some places, pharmacies have urgent care docs who can prescribe it on site. In other places, you'll need a prescription first. Ask your doctor if they'll prescribe it for you. In general, supplies are no longer limited, and we actually have Paxlovid going to waste because it's not being prescribed, which is a real shame.
posted by hydropsyche at 5:26 PM on April 25, 2022

Best answer: To get Paxlovid prescribed you will have to persuade your provider to order it, as there is a requirement to have risks of severe covid. My 32 year old vaxxed daughter got covid and was refused a script by her doctor for this reason. Fortunately, she had minimal symptoms and tested negative after 6 days.

Paxlovid seems to be very unevenly requested and offered, and unevenly stocked by pharmacies. If your insurance requires you to go to a specific chain, it might be worth calling to see if they have it in stock. Then, if your symptoms worsen you can push your doc a little if they are reluctant to prescribe it. Keep in mind that there is a fairly long list of contraindicated medications that you'll need to consult your provider about, including oral contraceptives - a list is easily accessible at the drug's website. I don't see PPIs among them, but of course you'll need to discuss this if your provider agrees to prescribe it. Good luck and I hope you feel better soon!
posted by citygirl at 6:17 PM on April 25, 2022

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