Association of Chronic Acid Suppression and Social Determinants of Health with COVID-19 Infection

Zhang, B.; Silverman, A. L.; Bangaru, S.; Arneson, D.; Dasharathy, S.; Nguyen, N.; Rodden, D.; Shih, J.; Butte, A. J.; El-Nachef, W. N.; Boland, B. S.; Rudrapatna, V. A.

Acid suppressants are a widely-used class of medications previously linked to an increased risk of aerodigestive infections. However, prior studies of these medications as potentially reversible risk factors for COVID-19 have been conflicting. We performed a case-control study involving clinician-abstracted data from 900 health records across 3 US medical centers. We incorporated sociobehavioral predictors of infectious exposure using geomapping to publicly-available data. We found no evidence for an association between chronic acid suppression and incident COVID-19 (adjusted odds ratio 1.04, 95% CI: 0.92-1.17, P=0.515). However, we identified several medical and social features as 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-onset infection. These results place both medical and social factors on the same scale within the context of the COVID-19 pandemic, and underscore the importance of comprehensive models of disease.