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0 0.5 1 1.5 2+ Case 13% Improvement Relative Risk UDCA for COVID-19  Ming et al.  Prophylaxis Does ursodeoxycholic acid reduce COVID-19 infections? Retrospective 8,864 patients in the United Kingdom Fewer cases with ursodeoxycholic acid (p=0.028) Ming et al., Microbiology and Infectio.., Nov 2023 Favors ursodeoxycholic acid Favors control

A Retrospective Study in Patients With Varying Prescription Coverage With Ursodeoxycholic Acid and Association With Incidence of COVID-19 Diagnosis in Primary Care

Ming et al., Microbiology and Infectious Diseases The American Medical Journal, doi:10.33590/microbiolinfectdisamj/10304488
Nov 2023  
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Retrospective 8,964 primary care patients prescribed ursodeoxycholic acid (UDCA) in the UK. Higher categorized UDCA adherence (≥80%) was associated with lower COVID-19 incidence (OR 0.86), whereas adherence as a continuous variable was not significant. However, adherence was measured indirectly via prescription records which may not reflect actual usage. Additionally, more adherent patients may differ systematically on unmeasured confounders (e.g., health behaviors) that influence COVID-19 risk.
2 preclinical studies support the efficacy of ursodeoxycholic acid for COVID-19:
risk of case, 12.9% lower, RR 0.87, p = 0.03, treatment 185 of 3,804 (4.9%), control 297 of 5,060 (5.9%), NNT 99, odds ratio converted to relative risk, high vs. low adherence.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Ming et al., 16 Nov 2023, retrospective, United Kingdom, peer-reviewed, 3 authors, high vs. low. Contact:
This PaperUDCAAll
A Retrospective Study in Patients With Varying Prescription Coverage With Ursodeoxycholic Acid and Association With Incidence of COVID-19 Diagnosis in Primary Care
Simon Wan Yau Ming Ming, Mike Smith, Yi Zhou
Microbiology and Infectious Diseases The American Medical Journal, doi:10.33590/microbiolinfectdisamj/10304488
Background: The 2019 novel coronavirus (COVID-19) pandemic resulted in significant mortality and morbidity. Ursodeoxycholic acid (UDCA) is reportedly widely in demand in some countries, such as China, to protect individuals from the effects of infection, as there is evidence that it is effective in preventing viral replication in some in vitro studies. UDCA is commonly prescribed in patients with primary biliary cirrhosis and gallbladder calculi. By evaluating a set of patients prescribed UDCA, whether or not the risk of COVID-19 infection is attenuated by adherence to UDCA can be determined. Method: This is a retrospective database study using the Clinical Practice Research Datalink (CPRD Aurum). Patients who received a prescription of UDCA in the study timeframe of March 1, 2020-May 30, 2021 were characterized, and their primary care electronic medical records analyzed for presence of COVID-19 infection. The proportion of days covered for each patient was used as a proxy for adherence. A comparison was made between categorized high-and low-adherence, and adherence as a continuous variable. Inverse probability weighting was used to adjust for confounding. Results: Higher categorized adherence (≥80%) to UDCA was associated with a statistically significant lower incidence of COVID-19 (odds ratio [OR]: 0.864; 95% confidence interval [CI]: 0.759-0.984; p=0.027). This contrasted to adherence as a continuous variable, which was not statistically significant. Obesity and hematological malignancy were also associated with a higher incidence of COVID-19 infection.
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