Proton pump inhibitors in invasively ventilated patients with SARS-CoV-2: a substudy of the re-evaluating the inhibition of stress erosions trial.
BMJ OpenAug 31, 2026 (epub)
Clinical ResearchGastroenterologyInfectious DiseasesPulmonologyInternal Medicine (General)Open access
Brittany Dennis, Diane Heels-Ansdell, Quazi Ibrahim et al.
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In 30 seconds
This substudy of the REVISE trial evaluated the effects of pantoprazole in 532 mechanically ventilated patients with SARS-CoV-2. It found that SARS-CoV-2 infection was linked to higher ICU, hospital, and 90-day mortality, as well as longer mechanical ventilation duration, but not to increased clinically important upper gastrointestinal bleeding. The adjusted hazard ratio for bleeding was 0.78.
Key findings
- SARS-CoV-2 infection was associated with higher ICU, hospital, and 90-day mortality.
- Patients with SARS-CoV-2 had longer durations of mechanical ventilation and ICU stays.
- Pantoprazole did not increase the risk of clinically important upper gastrointestinal bleeding.
- The effect of pantoprazole on bleeding was consistent regardless of SARS-CoV-2 status.
Why it matters
Understanding the impact of SARS-CoV-2 on critically ill patients is crucial for managing care in ICUs. The findings suggest that while mortality is higher in infected patients, pantoprazole can be safely used without increasing bleeding risk.