Ингибиторы протонной помпы в период пандемии COVID-19

Безопасность применения ингибиторов протонной помпы (ИПП) при коронавирусной инфекции (COVID-19) является недостаточно изученной. ИПП являются мощными супрессорами желудочной секреции и входят в десятку наиболее широко используемых препаратов в мире. Предполагается, что препараты влияют на восприимчивость к вирусу, тяжесть течения и исходы у пациентов с диагнозом COVID-19. Это беспокойство основано на механизме действия ИПП — подавлении кислотности желудочного сока, который считается первой линией защиты от инфекций. В совокупности результаты большинства исследований и метаанализов подтверждают возможность того, что использование ИПП может способствовать развитию более тяжелой формы COVID-19. Однако учесть все потенциальные факторы риска тяжести COVID-19 в реальной клинической практике представляется затруднительным, поэтому следует с большой осторожностью относиться к выводам о причинно-следственных связях применения ИПП. Дополнительная интересная точка зрения на использование ИПП во время пандемии заключается в том, что их прием может привести к снижению всасывания некоторых витаминов. С другой стороны, в литературе появилось несколько исследований в отношении защитных терапевтических эффектов ИПП. Все больше доказательств иммуномодулирующей и антифиброзной роли ИПП, что может быть использовано в лечении COVID-19. Кроме того, способность препаратов подщелачивать содержимое эндосом и лизосом служит препятствием для проникновения вируса в клетки. В представленном обзоре проанализированы возможные эффекты приема ИПП у пациентов с COVID-19.

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