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dcyphr | Famotidine Use is Associated with Improved Clinical Outcomes in Hospitalized COVID-19 Patients: A Retrospective Cohort Study

Abstract

Famotidine is a drug commonly used for gastric acid suppression. Some researchers have pointed to it possibly stopping SARS-CoV-2 replication. This study tested whether famotidine use is associated with better outcomes in COVID-19 patients. These patients were hospitalized in a non-intensive care setting. They were exposed to famotidine within 24 hours of hospital admittance. The study found that famotidine use was associated with a reduced risk for death or intubation, and for death alone. Proton pump inhibitors, a similar group of medications that suppress gastric acid, did not have this association of reduced risk. Further trials are needed to investigate the effects of famotidine therapy on hospitalized COVID-19 patients. 

Introduction

Famotidine stops gastric acid production. It is often prescribed for stress ulcer prophylaxis, which tends to cause gastrointestinal bleeding without abdominal pain. In vitro (i.e., test tube), famotidine has displayed antiviral capabilities by preventing HIV replication. Famotidine may inhibit 3CLpro, which is essential to SARS-Cov-2 replication. 

Methods

This study included adults admitted to Columbia University Irving Medical Center or the Allen Pavillion from February 25th to April 13, 2020. These patients tested positive for SARS-CoV-2 upon presentation or within 72 hours following admission. Patients surviving less than 48 hours after admission or requiring intubation within 48 hours after admission were excluded from the study. 

Results

Famotidine use was independently associated with risk for death or intubation (Table 2, adjusted hazard ratio (aHR) 0.42, 95%% CI 0.21-0.85). Age was also an independent predictor of poor outcomes in this study.

Conclusions 

In patients with COVID-19 who did not require urgent or semi-urgent intubation, famotidine use was associated with a significantly reduced risk of death or intubation. These results were specific for famotidine and COVID-19. The results also support the idea that famotidine use may decrease cytokine release during COVID-19 infection. These findings do not mean that famotidine has a protective effect in patients hospitalized with COVID-19.