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. 2021 Oct;43(5):2333-2343.
doi: 10.1007/s11357-021-00397-z. Epub 2021 Jul 17.

Therapeutic prevention of COVID-19 in elderly: a case-control study

Frederic Blanc  1 , Cedric Waechter  2 , Thomas Vogel  2 , Benoit Schorr  2 , Catherine Demuynck  2 , Catherine Martin Hunyadi  2 , Maxence Meyer  2 , Denata Mutelica  2 , Nadjiba Bougaa  2 , Samira Fafi-Kremer  3 , Lidia Calabrese  2 , Elise Schmitt  2 , Delphine Imperiale  2 , Catherine Jehl  2 , Alexandre Boussuge  2 , Carmen Suna  2 , François Weill  2 , Alexia Matzinger  2 , Candice Muller  2 , Patrick Karcher  2 , Georges Kaltenbach  2 , Erik Sauleau  4
Affiliations

Therapeutic prevention of COVID-19 in elderly: a case-control study

Frederic Blanc et al. Geroscience. 2021 Oct.

Abstract

COVID-19 is a particularly aggressive disease for the elderly as 86% of deaths related to COVID-19 occur in people over 65 years of age. Despite the urgent need for a preventive treatment, there are currently no serious leads, other than the vaccination. The aim of this retrospective case-control study is to find a pharmacological preventive treatment of COVID-19 in elderly patients. One-hundred-seventy-nine patients had been in contact with other COVID-19 patients at home or in hospital, of whom 89 had tested RT-PCR-positive (COVID-pos) for the virus and 90 had tested RT-PCR-negative (COVID-neg). Treatments within 15 days prior to RT-PCR (including antihypertensive drugs, antipsychotics, antibiotics, nonsteroidal anti-inflammatory drugs, proton pump inhibitors (PPIs), oral antidiabetics (OADs), corticosteroids, immunosuppressants), comorbidities, symptoms, laboratory values, and clinical outcome were all collected. COVID-pos patients more frequently had a history of diabetes (P = .016) and alcoholism (P = .023), a lower leukocyte count (P = .014) and a higher mortality rate - 29.2% versus 14.4% - (P = .014) when compared to COVID-neg patients. Patients on PPIs were 2.3 times less likely (odds ratio [OR] = 0.4381, 95% confidence interval [CI] [0.2331, 0.8175], P = .0053) to develop COVID-19 infection, compared to those not on PPIs. No other treatment decreased or increased this risk. COVID-pos patients on antipsychotics (P = .0013) and OADs (P = .0153), particularly metformin (P = .0237), were less likely to die. Thus, patients on treatment with PPI were less likely to develop COVID-19 infection, and those on antipsychotics or metformin had a lower risk of mortality. However, prospective studies, including clinical trials, are needed to confirm or not these findings.

Keywords: Antipsychotics; COVID-19; Elderly; Geriatrics; Metformin; Prevention; Proton pump inhibitors.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Probability of COVID-19 in elderly patients on proton pump inhibitors
See this image and copyright information in PMC

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