Ursodeoxycholic acid relieves clinical severity of COVID-19 in patients with chronic liver diseases

DOI record: { "DOI": "10.3389/fmed.2025.1494248", "ISSN": [ "2296-858X" ], "URL": "http://dx.doi.org/10.3389/fmed.2025.1494248", "abstract": "<jats:sec><jats:title>Background</jats:title><jats:p>The potential effect of ursodeoxycholic acid (UDCA) on the clinical outcomes of SARS-CoV-2 in patients with chronic liver diseases has been a subject of ongoing debate since the onset of the SARS-CoV-2 pandemic in 2019. This study aims to investigate the effect of UDCA on the prognosis of SARS-CoV-2 infection in patients with chronic liver diseases.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>A total of 926 patients with chronic liver diseases who contracted their first SARS-CoV-2 infection during December 2022 to January 2023, were included in this study. Participants were divided into two groups based on the use of UDCA: the UDCA cohort (<jats:italic>n</jats:italic> = 329) and the non-UDCA cohort (<jats:italic>n</jats:italic> = 597). After performing a 1:1 age-and sex-matching, the analysis proceeded with 309 patients from each group for further evaluation.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>In the UDCA-treated cohort, the incidence of asymptomatic SARS-CoV-2 infections was significantly higher, with 30.1% of patients affected, compared to 6.47% in the non-UDCA group (<jats:italic>p</jats:italic> &amp;lt; 0.0001). Multivariable analysis identified UDCA as a protective factor against symptomatic infections, yielding an odds ratio (OR) of 4.77 (95% CI: 2.70–8.44, <jats:italic>p</jats:italic> &amp;lt; 0.001). Furthermore, age over 50 was found to be a risk factor for asymptomatic infections in the UDCA cohort, with an adjusted OR of 1.51 (95% CI: 1.01–2.24, <jats:italic>p</jats:italic> = 0.05).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The study suggests that UDCA therapy may improve clinical outcomes in patients with chronic liver diseases patients who are infected with SARS-CoV-2, highlighting its potential role in improving prognosis within this vulnerable population. However, further research is required to validate these findings and to elucidate the mechanisms underlying UDCA’s protective effect.</jats:p></jats:sec>", "alternative-id": [ "10.3389/fmed.2025.1494248" ], "author": [ { "affiliation": [], "family": "Hu", "given": "Tiantian", "sequence": "first" }, { "affiliation": [], "family": "Tong", "given": "Jie", "sequence": "additional" }, { "affiliation": [], "family": "Yang", "given": "Yunhui", "sequence": "additional" }, { "affiliation": [], "family": "Yuan", "given": "Changrong", "sequence": "additional" }, { "affiliation": [], "family": "Zhang", "given": "Jiming", "sequence": "additional" }, { "affiliation": [], "family": "Wang", "given": "Jinyu", "sequence": "additional" } ], "container-title": "Frontiers in Medicine", "container-title-short": "Front. 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