ArticleJournal of internal medicine2023
Ursodeoxycholic acid is associated with a reduction in SARS-CoV-2 infection and reduced severity of COVID-19 in patients with cirrhosis.
Article in Journal of internal medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 39 citations in OpenAlex.
- Clinical effects of ursodeoxycholic acid in COVID-19 infection: a systematic review and dose-response meta-analysis.Frontiers in pharmacology · 2026Pooled it
- Clinical course, prognostic markers, and transplant implications in COVID-19-associated secondary sclerosing cholangitis.Journal of gastroenterology · 2026Article
- Drug Repurposing as a Broad-Spectrum Strategy Against Coronaviruses: Frontiers in Mechanisms and Clinical Translation.Viruses · 2026Review
- Ursodeoxycholic acid and long COVID in steatotic liver disease: a nationwide cohort study.Clinical and molecular hepatology · 2026Article
- Ursodeoxycholic acid treatment did not show protective effect for severe COVID-19 outcomes - a nationwide register study.BMC public health · 2026Article
- Use of Ursodeoxycholic Acid and the Risk of Severe Coronavirus Disease 2019 in Elderly Patients with Viral Hepatitis.Internal medicine (Tokyo, Japan) · 2025Observational
- Modelling the potential use of pre-exposure prophylaxis to reduce nosocomial SARS-CoV-2 transmission.PLoS computational biology · 2025Article
- Ursodeoxycholic acid and severe COVID-19 outcomes in a cohort study using the OpenSAFELY platform.Communications medicine · 2024Article
- Bile Acid Signaling in Metabolic and Inflammatory Diseases and Drug Development.Pharmacological reviews · 2024Review
- Association Between Ursodeoxycholic Acid and Clinical Outcomes in Patients With COVID-19 Infection: Population-Based Cohort Study.JMIR public health and surveillance · 2024Article
- Association between ursodeoxycholic acid use and COVID-19 in individuals with chronic liver disease: a nationwide case-control study in South Korea.Virology journal · 2024Article
- The Value of Ursodeoxycholic Acid and Mesenchymal Stem Cells in the Treatment of Severe COVID-19.Microorganisms · 2024Article
- Bile acids and coronavirus disease 2019.Acta pharmaceutica Sinica. B · 2024Review
- Article
- Evaluating the protective effectiveness and risk factors of ursodeoxycholic acid on COVID-19 among outpatients.Frontiers in pharmacology · 2024Article
- Ursodeoxycholic acid does not reduce SARS-CoV-2 infection in newly allogeneic hematopoietic stem cell transplantation recipients: a prospective NICHE cohort.Frontiers in cellular and infection microbiology · 2024Observational
- Type 1 Diabetes and COVID-19: A Literature Review and Possible Management.International journal of endocrinology and metabolism · 2023Review
- Post-COVID-19 cholangiopathy: Systematic review.World journal of methodology · 2023Article
- Article
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Authors and funding
15 authors at 11 institutions in 2 countries.
Funding
Abstract
BACKGROUND AND
aimsStudies have demonstrated that reducing farnesoid X receptor activity with ursodeoxycholic acid (UDCA) downregulates angiotensin-converting enzyme in human lung, intestinal and cholangiocytes organoids in vitro, in human lungs and livers perfused ex situ, reducing internalization of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) into the host cell. This offers a potential novel target against coronavirus disease 2019 (COVID-19). The objective of our study was to compare the association between UDCA exposure and SARS-CoV-2 infection, as well as varying severities of COVID-19, in a large national cohort of participants with cirrhosis.
methodsIn this retrospective cohort study among participants with cirrhosis in the Veterans Outcomes and Costs Associated with Liver cohort, we compared participants with exposure to UDCA, with a propensity score (PS) matched group of participants without UDCA exposure, matched for clinical characteristics, and vaccination status. The outcomes included SARS-CoV-2 infection, symptomatic, at least moderate, severe, or critical COVID-19, and COVID-19-related death.
resultsWe compared 1607 participants with cirrhosis who were on UDCA, with 1607 PS-matched controls. On multivariable logistic regression, UDCA exposure was associated with reduced odds of developing SARS-CoV-2 infection (adjusted odds ratio [aOR] 0.54, 95% confidence interval [CI] 0.41-0.71, p < 0.0001). Among patients who developed COVID-19, UDCA use was associated with reduced disease severity, including symptomatic COVID-19 (aOR 0.54, 95% CI 0.39-0.73, p < 0.0001), at least moderate COVID-19 (aOR 0.51, 95% CI 0.32-0.81, p = 0.005), and severe or critical COVID-19 (aOR 0.48, 95% CI 0.25-0.94, p = 0.03).
conclusionsIn participants with cirrhosis, UDCA exposure was associated with both a decrease in SARS-CoV-2 infection, and reduction in symptomatic, at least moderate, and severe/critical COVID-19.
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