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Is a heartburn drug secretly saving COVID-19 patients?

A common heartburn drug has become a potential candidate for treating COVID-19. Recent studies were launched after experts noticed a surprising pattern in medical records from the early days of the COVID-19 pandemic in Wuhan, China.

Many of the elderly patients that managed to survive the infection in Wuhan had two things in common: they were poor and suffered from chronic heartburn.

Researchers found that these particular elderly survivors were taking an inexpensive heartburn drug called famotidine, which is the key ingredient in Pepcid. 

On the other hand, wealthier patients tend to take omeprazole, a more expensive ingredient that is found in Prilosec.

A team of experts in the University of Virginia School of Engineering and Applied Science set out to investigate whether this over-the-counter heartburn drug was actually helping people survive COVID-19. Study co-author Phil Bourne, a professor of Biomedical Engineering, explained that this is how many medical studies begin.

“There’s often a phenomenon that doctors report anecdotally, or that’s mentioned in passing in a particular research paper, and that provides a clue – a hook,” said Professor Bourne.

Under normal circumstances, scientists use clinical trials to determine whether a drug is effective in treating a particular medical condition. Professor Bourne noted that this method is expensive and can take years.

To speed up the process, Professor Bourne and UVA senior scientist Cameron Mura worked with an international team of researchers, utilizing information from a database that contains the medical records of millions of COVID-19 patients in 30 different countries. The experts zeroed in on about 22,000 patients who were taking the heartburn relief drug famotidine. 

“The power of the electronic health record, which is really yet to be fully realized as a research tool, is that you’ve suddenly got all this data you can mine to see whether what you determined in passing or anecdotally has any basis,” said Professor Bourne.

The analysis showed that when delivered at high doses, or the equivalent of about 10 Pepcid tablets, famotidine appears to improve the odds of survival for COVID-19 patients. This was particularly true when the drug was combined with aspirin. 

According to the researchers, the heartburn drug also seems to hinder the severity of disease progression, making patients less likely to reach the point where they require intubation or a ventilator.

Patients with severe COVID-19 often experience something called a cytokine storm, a potentially deadly immune response. 

“Basically, your immune system goes haywire and starts attacking things like your otherwise healthy lung tissue because it’s so desperate to kill off the invading virus,” said Mura. “Your own physiology essentially uses a sledgehammer against the pathogen when a fly swatter would suffice.”

The experts theorize that famotidine suppresses that reaction. Like all other medications, this heartburn drug can cause side effects, and the researchers believe that interfering with cytokine storms might be one of them.

“It may well be a case of famotidine having a beneficial off-target effect,” said Mura. Side effects are typically perceived as a bad thing, but in cases like this, they could be very useful. 

Despite the team’s hopeful findings, further research is urgently needed. Previous studies have offered conflicting results on the effects of famotidine on COVID-19 patients. One study even suggested that the heartburn drug could be detrimental. 

“Scientific studies are sometimes viewed as the end-all, be-all, but they’re really just a starting point or a springboard,” said Mura. “Any good study raises more questions than it answers, and data science is often what kick-starts that process.”

The study is published in the journal Signal Transduction & Targeted Therapy from the Nature publishing group.

By Chrissy Sexton, Staff Writer

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