Could the severity of COVID-19 be increased by low gastric acidity? | Critical Care | Full Text
**** {Effects of Prilosec/omeprazole} "the pH of normal gastric acid is generally between 1.5 and 3.5. The SARS-CoV-1 virus is inactivated at a pH 12.0 [5]. Assuming these inactivation levels are similar for SARS-CoV-2, gastric acid will not inhibit all the viruses in the stomach (and some viruses will be hidden in food boluses). However, the inhibition that does occur may be enough to decrease the viral load entering the small intestine. In many older adults, the gastric acid pH is higher than normal, either because of atrophic gastritis or because of antacid and acid-reducing medications. One oral dose of a proton pump inhibitor raises the gastric acid pH from 2.0 to over 6.0, which will not inhibit the virus" "abdominal pain was associated with a near fourfold increased odds of severe disease," "many intubated patients are given acid-reducing drugs and gastrointestinal feeding may be continuous rather than intermittent. Such factors could result in a gastric pH of around 4.0 or 5.0. This would not inactivate these viruses, which might then pass into the small intestine where the relevant ACE2 receptors are abundant."