Evidence map›Paper›PMID 39562612›Full record

ArticleCommunications medicine2024

Ursodeoxycholic acid and severe COVID-19 outcomes in a cohort study using the OpenSAFELY platform.

Ruth E Costello, Karen M J Waller, Rachel Smith, George F Mells, Angel Y S Wong, Anna Schultze, Viyaasan Mahalingasivam, Emily Herrett, Bang Zheng, Liang-Yu Lin and 9 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Communications medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Ruth E CostelloLondon School of Hygiene and Tropical Medicine, London, UK. ruth.costello@lshtm.ac.uk.ORCID http://orcid.org/0000-0003-2709-6666
Karen M J WallerCollaborative Centre for Organ Donation Evidence, Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia.
Rachel SmithCambridge Liver Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
George F MellsCambridge Liver Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Angel Y S WongLondon School of Hygiene and Tropical Medicine, London, UK.ORCID http://orcid.org/0000-0002-8618-7333
Anna SchultzeLondon School of Hygiene and Tropical Medicine, London, UK.
Viyaasan MahalingasivamLondon School of Hygiene and Tropical Medicine, London, UK.
Emily HerrettLondon School of Hygiene and Tropical Medicine, London, UK.ORCID http://orcid.org/0000-0002-9425-644X
Bang ZhengLondon School of Hygiene and Tropical Medicine, London, UK.
Liang-Yu LinLondon School of Hygiene and Tropical Medicine, London, UK.
Brian MacKennaBennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Amir MehrkarBennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID http://orcid.org/0000-0002-2098-1278
Sebastian C J BaconBennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Ben GoldacreBennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Laurie A TomlinsonLondon School of Hygiene and Tropical Medicine, London, UK.ORCID http://orcid.org/0000-0001-8848-9493
John TazareLondon School of Hygiene and Tropical Medicine, London, UK.
Christopher T RentschLondon School of Hygiene and Tropical Medicine, London, UK.ORCID http://orcid.org/0000-0002-1408-7907
OpenSAFELY collaborative
LH&W NCS (or CONVALESCENCE) Collaborative

Funding

DH | National Institute for Health Research (NIHR) COV-LT-0009DH | National Institute for Health Research (NIHR) NIHR135559Medical Research Council MR/V015737/1Medical Research Council MR/W016729/1
6 · The paper itself

Abstract

backgroundBiological evidence suggests ursodeoxycholic acid (UDCA)-a common treatment of cholestatic liver disease-may prevent severe COVID-19 outcomes. We aimed to compare the hazard of COVID-19 hospitalisation or death between UDCA users versus non-users in a population with primary biliary cholangitis (PBC) or primary sclerosing cholangitis (PSC).

methodsWith the approval of NHS England, we conducted a population-based cohort study using primary care records between 1 March 2020 and 31 December 2022, linked to death registration data and hospital records through the OpenSAFELY-TPP platform. Cox proportional hazards regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association between time-varying UDCA exposure and COVID-19 related hospitalisation or death, stratified by geographical region and considering models unadjusted and fully adjusted for pre-specified confounders.

resultsWe identify 11,305 eligible individuals, 640 were hospitalised or died with COVID-19 during follow-up, 400 (63%) events among UDCA users. After confounder adjustment, UDCA is associated with a 21% relative reduction in the hazard of COVID-19 hospitalisation or death (HR 0.79, 95% CI 0.67-0.93), consistent with an absolute risk reduction of 1.35% (95% CI 1.07%-1.69%).

conclusionsWe found evidence that UDCA is associated with a lower hazard of COVID-19 related hospitalisation and death, support calls for clinical trials investigating UDCA as a preventative measure for severe COVID-19 outcomes.

Identifiers

PMID39562612
PMCPMC11576861

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.