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0 0.5 1 1.5 2+ Mortality 0% Improvement Relative Risk UDCA for COVID-19  Colapietro et al.  LATE TREATMENT Is late treatment with ursodeoxycholic acid beneficial for COVID-19? Retrospective 3,847 patients in Italy (January 2020 - January 2023) No significant difference in mortality Colapietro et al., Viruses, August 2023 Favors ursodeoxycholic acid Favors control

Ursodeoxycholic Acid Does Not Improve COVID-19 Outcome in Hospitalized Patients

Colapietro et al., Viruses, doi:10.3390/v15081738
Aug 2023  
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Retrospective 3,847 COVID-19 patients hospitalized in Italy, including 57 treated with UDCA. UDCA treatment was not associated with reduced mortality, however treatment was associated with a lower rate of CPAP use. It's not clear how the upper confidence interval for mortality can be so much closer to the point estimate (0.01 vs. 0.31). Conflicting values are given for the CPAP OR 0.88 and 0.76.
risk of death, no change, OR 1.00, p = 0.24, treatment 57, control 3,790, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Colapietro et al., 14 Aug 2023, retrospective, Italy, peer-reviewed, 19 authors, study period January 2020 - January 2023. Contact: (corresponding author),,,,,
This PaperUDCAAll
Ursodeoxycholic Acid Does Not Improve COVID-19 Outcome in Hospitalized Patients
Francesca Colapietro, Giovanni Angelotti, Chiara Masetti, Dana Shiffer, Nicola Pugliese, Stella De Nicola, Francesco Carella, Antonio Desai, Monica Ormas, Marta Calatroni, Paolo Omodei, Michele Ciccarelli, Stefano Aliberti, Francesco Reggiani, Michele Bartoletti, Maurizio Cecconi, Ana Lleo, Alessio Aghemo, Antonio Voza
Viruses, doi:10.3390/v15081738
Ursodeoxycholic acid (UDCA) was demonstrated to reduce susceptibility to SARS-CoV-2 infection in vitro and improve infection course in chronic liver diseases. However, real-life evidence is lacking. We analyzed the impact of UDCA on COVID-19 outcomes in patients hospitalized in a tertiary center. Between January 2020 and January 2023, among 3847 patients consecutively hospitalized for COVID19, 57 (=UDCA group) were taking UDCA. The UDCA and the control groups (n = 3790) did not differ concerning comorbidities including diabetes mellitus type 2 (15.8% vs. 12.8%) and neoplasia (12.3% vs. 9.4%). Liver diseases and vaccination rate were more common in the UDCA group (14.0% vs. 2.5% and 54.4% vs. 30.2%, respectively). Overall mortality and CPAP treatment were 22.8 % and 15.7% in the UDCA, and 21.3% and 25.9% in the control group. Mortality was similar (p = 0.243), whereas UDCA was associated with a lower rate of CPAP treatment (OR = 0.76, p < 0.05). Treatment with UDCA was not an independent predictor of survival in patients hospitalized for COVID-19.
Funding: The authors did not receive any financial support in order to complete the study or write the manuscript. Informed Consent Statement: Not applicable. Conflicts of Interest: All the authors have given substantial contribution to the completion of this work and have seen and approved the text in the current version. None reported a conflict of interest with respect to this manuscript. Abbreviations UDCA: ursodeoxycholic acid; PBC: primary biliary cholangitis; CPAP: continuous positive airway pressure; HER: electronic health record; SQL: Structured Query Language; AH: arterial hypertension; DM: diabetes mellitus; CKD: chronic kidney disease; COPD: chronic obstructive pulmonary disease; LFT: liver function test; PLT: platelets; OR: odds ratio; CI: confidence interval; ACE2: angiotensin-converting enzyme 2; FXR: farnesoid X receptor; ICU: intensive care unit; IQR: interquartile range.
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Late treatment
is less effective
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