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UDCA for COVID-19
19 studies from 235 scientists
43,512 patients in 7 countries
Statistically significant lower risk for progression, recovery, and cases.
12 studies from 11 independent teams in 4 countries show significant improvements.
COVID-19 UDCA studies. Nov 2024. c19early.org
0 0.5 1 1.5+ All studies 20% With exclusions 18% Mortality 16% Hospitalization 17% Recovery 41% Cases 16% Prophylaxis 19% Late 39% FavorsUDCA Favorscontrol
Nov 21
Covid Analysis Ursodeoxycholic acid for COVID-19: real-time meta analysis of 19 studies
Statistically significant lower risk is seen for progression, recovery, and cases. 12 studies from 11 independent teams in 4 countries show significant improvements. Meta analysis using the most serious outcome reported shows 20% [-2..
Sep 27
Sakamaki et al., Discover Public Health, doi:10.1186/s12982-024-00225-7 Insights from a multicenter nationwide cohort analysis in Japan on the association of underlying conditions and pharmacological interventions with COVID-19 disease severity
79% higher severe cases (p<0.0001). Retrospective 650,317 COVID-19 patients in Japan showing higher risk of severe COVID-19 with UDCA use. There may be significant residual confounding because authors do not appear to have adjusted for liver diseases (details of adjustments..
Aug 27
Moon et al., Virology Journal, doi:10.1186/s12985-024-02464-1 Association between ursodeoxycholic acid use and COVID-19 in individuals with chronic liver disease: a nationwide case-control study in South Korea
33% lower severe cases (p=0.04) and 20% fewer cases (p<0.0001). Retrospective 74,074 individuals with chronic liver disease in South Korea, showing lower risk of COVID-19 infection and related severe outcomes with ursodeoxycholic acid (UDCA) use. The risk reduction was dose-dependent, with greater ben..
Aug 14
Lee et al., JMIR Public Health and Surveillance, doi:10.2196/59274 Association Between Ursodeoxycholic Acid and Clinical Outcomes in Patients With COVID-19 Infection: Population-Based Cohort Study
Retrospective 1,675,593 patients in the Jeonbuk CDM cohort and 8,528,533 patients in the NHIS cohort, showing ursodeoxycholic acid (UDCA) intake associated with significantly lower risk of COVID-19 infection and severe COVID-19.
Jul 31
Li et al., Frontiers in Pharmacology, doi:10.3389/fphar.2024.1381830 Evaluating the protective effectiveness and risk factors of ursodeoxycholic acid on COVID-19 among outpatients
21% fewer symptomatic cases (p=0.001), 19% fewer cases (p=0.004), and 18% lower progression (p=0.04). Retrospective 1,040 outpatients in China showing lower COVID-19 cases, less severe symptoms, and shorter symptom duration with ursodeoxycholic acid (UDCA) use.
Jul 25
Jia et al., Journal of Clinical Hepatology, doi:10.12449/JCH240714 Effect of ursodeoxycholic acid on symptoms after severe acute respiratory syndrome coronavirus 2 infection in patients with primary biliary cholangitis and their family members
Retrospective 171 primary biliary cholangitis (PBC) patients taking ursodeoxycholic acid (UDCA) and 128 family members, showing no reduction in SARS-CoV-2 infection rates but milder symptoms in PBC patients. All PBC patients and family me..
Jul 8
Yu et al., Expert Review of Anti-infective Therapy, doi:10.1080/14787210.2024.2376153 Ursodeoxycholic acid and COVID-19 outcomes: a cohort study and data synthesis of state-of-art evidence
3% lower mortality (p=0.5) and 32% lower severe cases (p=0.02). Meta analysis of 9 studies showing lower risk of severe/critical COVID-19 with UDCA. There was no significant difference for mortality. Authors also perform a retrospective study which is listed separately [Yu].
Jul 8
Yu et al., Expert Review of Anti-infective Therapy, doi:10.1080/14787210.2024.2376153 Ursodeoxycholic acid and COVID-19 outcomes: a cohort study and data synthesis of state-of-art evidence
39% faster recovery (p=0.04). Retrospective 115 hospitalized COVID-19 patients in China showing faster time to body temperature recovery with ursodeoxycholic acid (UDCA) treatment. Results were better for higher dose treatment (300mg vs. 150mg). Authors also perform a..
Jun 22
Zheng et al., Microorganisms, doi:10.3390/microorganisms12071269 The Value of Ursodeoxycholic Acid and Mesenchymal Stem Cells in the Treatment of Severe COVID-19
62% lower mortality (p=0.03). Retrospective 167 severe COVID-19 patients showing lower mortality with ursodeoxycholic acid (UDCA). Timing and duration of treatment is unknown - UDCA patients may have been on UDCA since before COVID-19.
Apr 4
Lee et al., Pharmacology Research & Perspectives, doi:10.1002/prp2.1194 Ursodeoxycholic acid may protect from severe acute respiratory syndrome coronavirus 2 Omicron variant by reducing angiotensin‐converting enzyme 2
Syrian hamster study showing ursodeoxycholic acid (UDCA) may protect against SARS-CoV-2 omicron variant transmission and infection. Hamsters treated prophylactically with oral UDCA had significantly less weight loss compared to untreated ..
Mar 20
Cui et al., Journal of Clinical Hepatology, doi:10.12449/JCH240309 Efficacy of ursodeoxycholic acid in the prevention and treatment of COVID-19 in patients with chronic hepatitis B
48% faster recovery (p=0.01) and 83% fewer cases (p=0.001). Retrospective 215 patients with chronic hepatitis B in China, showing lower risk of COVID-19 infection, milder symptoms, and faster recovery with ursodeoxycholic acid (UDCA) treatment.
Feb 13
Huang et al., Acta Pharmaceutica Sinica B, doi:10.1016/j.apsb.2024.02.011 Bile acids and coronavirus disease 2019
Review of the relationship between bile acids and COVID-19. Authors discuss emerging basic and clinical evidence linking bile acids to COVID-19 infection and potential mechanisms. Functionally, studies indicate that certain bile acids lik..
Jan 19
Corpechot et al., Journal of Medical Virology, doi:10.1002/jmv.29418 Exploring the impact of ursodeoxycholic acid therapy on COVID‐19 in a real‐world setting
19% lower ICU admission (p=1) and 40% lower hospitalization (p=0.17). Retrospective cohort study of 10,147 chronic liver disease patients in France, with 1,322 exposed to ursodeoxycholic acid (UDCA), showing lower risk of hospitalization for COVID-19 with UDCA exposure, without statistical significance (adj..
Dec 13
2023
Costello et al., medRxiv, doi:10.1101/2023.12.11.23299191 Ursodeoxycholic acid and severe COVID-19 outcomes in people with liver disease: a cohort study using the OpenSAFELY platform
24% lower mortality (p=0.13), 19% lower hospitalization (p=0.02), and 21% lower combined mortality/hospitalization (p=0.005). OpenSAFELY retrospective 11,320 primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC) patients showing lower risk of COVID-19 hospitalization or death with ursodeoxycholic acid (UDCA) treatment.
Dec 9
2023
Fiorucci et al., Biochemical Pharmacology, doi:10.1016/j.bcp.2023.115983 Bile acids and bile acid activated receptors in the treatment of Covid-19
Review of the potential role of bile acids and bile acid activated receptors in modulating SARS-CoV-2 infectivity and inflammation in COVID-19. Authors discuss mechanisms by which bile acids like ursodeoxycholic acid (UDCA), chenodeoxycho..
Nov 28
2023
Gao et al., Blood, doi:10.1182/blood-2023-182862 Effect of Ursodeoxycholic Acid for Sars-Cov-2 Prevention in Hematological Malignancies: An Observational Real-World Study
12% fewer cases (p=0.03). Retrospective 393 hospitalized patients with hematologic disorders in China, showing lower risk of COVID-19 with UDCA use.
Nov 16
2023
Ming et al., Microbiology and Infectious Diseases The American Medical Journal, doi:10.33590/microbiolinfectdisamj/10304488 A Retrospective Study in Patients With Varying Prescription Coverage With Ursodeoxycholic Acid and Association With Incidence of COVID-19 Diagnosis in Primary Care
13% fewer cases (p=0.03). 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 no..
Sep 21
2023
Marrone et al., Liver International, doi:10.1111/liv.15736 Ursodeoxycholic acid does not affect the clinical outcome of SARS‐CoV‐2 infection: A retrospective study of propensity score‐matched cohorts
7% higher mortality (p=0.77). PSM retrospective 629 hospitalized COVID-19 patients showing no significant difference in survival between 108 patients taking UDCA prior to infection compared to 521 matched controls not taking the drug. The lack of observed benefit in t..
Aug 22
2023
Ojeda‐Fernández et al., Journal of Internal Medicine, doi:10.1111/joim.13711 UDCA treatment against COVID‐19: Do we have enough clinical evidence for drug repurposing?
7% higher mortality (p=0.67), 4% lower ICU admission (p=0.96), 6% higher hospitalization (p=0.66), and 3% fewer cases (p=0.77). Retrospective cohort study of 9,617 patients with liver disease in Italy, divided into UDCA users and non-users. UDCA exposure was not associated with reduced SARS-CoV-2 infection or improved COVID-19 outcomes including death, hospitaliza..
Aug 14
2023
Colapietro et al., Viruses, doi:10.3390/v15081738 Ursodeoxycholic Acid Does Not Improve COVID-19 Outcome in Hospitalized Patients
no change in mortality (p=0.24). 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 ..
Jul 27
2023
Okushin et al., Journal of Internal Medicine, doi:10.1111/joim.13704 Ursodeoxycholic acid for coronavirus disease 2019 prevention
17% fewer symptomatic cases (p=0.81) and no change in cases (p=1). Retrospective 94 outpatients attending a university hospital gastroenterology clinic in Japan showing no significant difference in SARS-CoV-2 infection rates between ursodeoxycholic acid (UDCA)-treated patients and control groups without ..
Jun 29
2023
Liu et al., Liver International, doi:10.1111/liv.15660 Ursodeoxycholic acid administration did not reduce susceptibility to SARS‐CoV‐2 infection in children
2% more cases (p=0.88). Retrospective 280 Chinese families with children previously seen in a liver clinic assessing whether ursodeoxycholic acid (UDCA) reduced SARS-CoV-2 infection risk. Among infected families, the study found no significant difference in conf..
May 4
2023
Yu et al., medRxiv, doi:10.1101/2023.05.02.23289410 UDCA May Promote COVID-19 Recovery: A Cohort Study with AI-Aided Analysis
38% improved recovery (p=0.05). Retrospective 115 COVID-19 patients hospitalized during an Omicron outbreak in China, of which 65 received ursodeoxycholic acid (UDCA) treatment and 50 received standard care. It found that UDCA was associated with faster body temperature..
May 3
2023
Li et al., Frontiers in Cellular and Infection Microbiology, doi:10.3389/fcimb.2023.1178590 Protective effect of ursodeoxycholic acid on COVID-19 in patients with chronic liver disease
80% lower severe cases (p=0.22), 80% fewer moderate/severe cases (p<0.0001), and 11% fewer cases (p=0.05). Retrospective propensity score matched cohort study of 225 chronic liver disease patients on UDCA therapy matched to 225 controls without UDCA in China. UDCA use was associated with lower COVID-19 infection rate (85% vs 94%), lower maximu..
Apr 5
2023
John et al., Journal of Internal Medicine, doi:10.1111/joim.13630 Ursodeoxycholic acid is associated with a reduction in SARS‐CoV‐2 infection and reduced severity of COVID‐19 in patients with cirrhosis
42% lower mortality (p=0.28), 54% lower severe cases (p=0.03), 55% fewer moderate/severe cases (p=0.002), and 50% fewer symptomatic cases (p<0.0001). Retrospective 3,214 veterans with cirrhosis comparing 1,607 participants taking ursodeoxycholic acid (UDCA) to 1,607 propensity score matched controls not taking UDCA. UDCA use was associated with significantly lower odds of SARS-CoV-2 in..
Dec 5
2022
Brevini et al., Nature, doi:10.1038/s41586-022-05594-0 FXR inhibition may protect from SARS-CoV-2 infection by reducing ACE2
94% lower mortality (p=0.13), 75% lower ICU admission (p=0.21), and 40% lower hospitalization (p=0.03). Retrospective study from two registries of 1,096 COVID-19 patients with chronic liver disease, including 31 treated with ursodeoxycholic acid (UDCA). Propensity score matching was used to compare outcomes between UDCA-treated and untreate..
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