Ursodeoxycholic acid does not affect the clinical outcome of SARS‐CoV‐2 infection: A retrospective study of propensity score‐matched cohorts

Background Ursodeoxycholic acid (UDCA) has been recently proposed as a modulator of angiotensin‐converting enzyme 2 (ACE2) receptor expression, with potential effects on COVID‐19. Aim and Study Design We retrospectively evaluated the clinical course and outcome of subjects taking UDCA admitted to th...

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Published inLiver international Vol. 44; no. 1; pp. 83 - 92
Main Authors Marrone, Giuseppe, Covino, Marcello, Merra, Giuseppe, Piccioni, Andrea, Amodeo, Annamaria, Novelli, Angela, Murri, Rita, Pompili, Maurizio, Gasbarrini, Antonio, Franceschi, Francesco
Format Journal Article
LanguageEnglish
Published United States Wiley Subscription Services, Inc 01.01.2024
Subjects
ACE2
Angiotensin
Angiotensin-converting enzyme 2
Comorbidity
COVID-19
Death
Emergency medical care
Health services
Hospitals
Multivariate analysis
Pneumonia
Rank tests
Regression analysis
SARS‐CoV‐2
Severe acute respiratory syndrome coronavirus 2
Survival
Survival analysis
UDCA
Ursodeoxycholic acid
Viral diseases
COVID-19
SARS-CoV-2
UDCA
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Abstract Background Ursodeoxycholic acid (UDCA) has been recently proposed as a modulator of angiotensin‐converting enzyme 2 (ACE2) receptor expression, with potential effects on COVID‐19. Aim and Study Design We retrospectively evaluated the clinical course and outcome of subjects taking UDCA admitted to the hospital for COVID‐19 compared with matched infected subjects. Differences regarding the severity and outcome of the disease between treated and non‐treated subjects were assessed. The Kaplan–Meier survival analysis and log‐rank test were used to evaluate the effect of UDCA on all‐cause intra‐hospital mortality. Results Among 6444 subjects with confirmed COVID‐19 admitted to the emergency department (ED) from 1 March 2020 to 31 December 2022, 109 subjects were taking UDCA. After matching 629 subjects were included in the study: 521 in the no UDCA group and 108 in the UDCA group. In our matched cohort, 144 subjects (22.9%) died, 118 (22.6%) in the no‐UDCA group and 26 (24.1%) in the UDCA group. The Kaplan–Meier analysis showed no significant difference in survival between groups. In univariate regression analysis, the presence of pneumonia, National Early Warning Score (NEWS) score, and Charlson Comorbidity Index (CCI) were significant independent predictors of death. At multivariate Cox regression analysis, age, NEWS, pneumonia and CCI index were confirmed significant independent predictors of death. UDCA treatment was not a predictor of survival both in univariate and multivariate regressions. Conclusions UDCA treatment does not appear to have significant effects on the outcome of COVID‐19. Specially designed prospective studies are needed to evaluate efficacy in preventing infection and severe disease.
AbstractList Ursodeoxycholic acid (UDCA) has been recently proposed as a modulator of angiotensin-converting enzyme 2 (ACE2) receptor expression, with potential effects on COVID-19. We retrospectively evaluated the clinical course and outcome of subjects taking UDCA admitted to the hospital for COVID-19 compared with matched infected subjects. Differences regarding the severity and outcome of the disease between treated and non-treated subjects were assessed. The Kaplan-Meier survival analysis and log-rank test were used to evaluate the effect of UDCA on all-cause intra-hospital mortality. Among 6444 subjects with confirmed COVID-19 admitted to the emergency department (ED) from 1 March 2020 to 31 December 2022, 109 subjects were taking UDCA. After matching 629 subjects were included in the study: 521 in the no UDCA group and 108 in the UDCA group. In our matched cohort, 144 subjects (22.9%) died, 118 (22.6%) in the no-UDCA group and 26 (24.1%) in the UDCA group. The Kaplan-Meier analysis showed no significant difference in survival between groups. In univariate regression analysis, the presence of pneumonia, National Early Warning Score (NEWS) score, and Charlson Comorbidity Index (CCI) were significant independent predictors of death. At multivariate Cox regression analysis, age, NEWS, pneumonia and CCI index were confirmed significant independent predictors of death. UDCA treatment was not a predictor of survival both in univariate and multivariate regressions. UDCA treatment does not appear to have significant effects on the outcome of COVID-19. Specially designed prospective studies are needed to evaluate efficacy in preventing infection and severe disease.
Background Ursodeoxycholic acid (UDCA) has been recently proposed as a modulator of angiotensin‐converting enzyme 2 (ACE2) receptor expression, with potential effects on COVID‐19. Aim and Study Design We retrospectively evaluated the clinical course and outcome of subjects taking UDCA admitted to the hospital for COVID‐19 compared with matched infected subjects. Differences regarding the severity and outcome of the disease between treated and non‐treated subjects were assessed. The Kaplan–Meier survival analysis and log‐rank test were used to evaluate the effect of UDCA on all‐cause intra‐hospital mortality. Results Among 6444 subjects with confirmed COVID‐19 admitted to the emergency department (ED) from 1 March 2020 to 31 December 2022, 109 subjects were taking UDCA. After matching 629 subjects were included in the study: 521 in the no UDCA group and 108 in the UDCA group. In our matched cohort, 144 subjects (22.9%) died, 118 (22.6%) in the no‐UDCA group and 26 (24.1%) in the UDCA group. The Kaplan–Meier analysis showed no significant difference in survival between groups. In univariate regression analysis, the presence of pneumonia, National Early Warning Score (NEWS) score, and Charlson Comorbidity Index (CCI) were significant independent predictors of death. At multivariate Cox regression analysis, age, NEWS, pneumonia and CCI index were confirmed significant independent predictors of death. UDCA treatment was not a predictor of survival both in univariate and multivariate regressions. Conclusions UDCA treatment does not appear to have significant effects on the outcome of COVID‐19. Specially designed prospective studies are needed to evaluate efficacy in preventing infection and severe disease.
Ursodeoxycholic acid (UDCA) has been recently proposed as a modulator of angiotensin-converting enzyme 2 (ACE2) receptor expression, with potential effects on COVID-19.BACKGROUNDUrsodeoxycholic acid (UDCA) has been recently proposed as a modulator of angiotensin-converting enzyme 2 (ACE2) receptor expression, with potential effects on COVID-19.We retrospectively evaluated the clinical course and outcome of subjects taking UDCA admitted to the hospital for COVID-19 compared with matched infected subjects. Differences regarding the severity and outcome of the disease between treated and non-treated subjects were assessed. The Kaplan-Meier survival analysis and log-rank test were used to evaluate the effect of UDCA on all-cause intra-hospital mortality.AIM AND STUDY DESIGNWe retrospectively evaluated the clinical course and outcome of subjects taking UDCA admitted to the hospital for COVID-19 compared with matched infected subjects. Differences regarding the severity and outcome of the disease between treated and non-treated subjects were assessed. The Kaplan-Meier survival analysis and log-rank test were used to evaluate the effect of UDCA on all-cause intra-hospital mortality.Among 6444 subjects with confirmed COVID-19 admitted to the emergency department (ED) from 1 March 2020 to 31 December 2022, 109 subjects were taking UDCA. After matching 629 subjects were included in the study: 521 in the no UDCA group and 108 in the UDCA group. In our matched cohort, 144 subjects (22.9%) died, 118 (22.6%) in the no-UDCA group and 26 (24.1%) in the UDCA group. The Kaplan-Meier analysis showed no significant difference in survival between groups. In univariate regression analysis, the presence of pneumonia, National Early Warning Score (NEWS) score, and Charlson Comorbidity Index (CCI) were significant independent predictors of death. At multivariate Cox regression analysis, age, NEWS, pneumonia and CCI index were confirmed significant independent predictors of death. UDCA treatment was not a predictor of survival both in univariate and multivariate regressions.RESULTSAmong 6444 subjects with confirmed COVID-19 admitted to the emergency department (ED) from 1 March 2020 to 31 December 2022, 109 subjects were taking UDCA. After matching 629 subjects were included in the study: 521 in the no UDCA group and 108 in the UDCA group. In our matched cohort, 144 subjects (22.9%) died, 118 (22.6%) in the no-UDCA group and 26 (24.1%) in the UDCA group. The Kaplan-Meier analysis showed no significant difference in survival between groups. In univariate regression analysis, the presence of pneumonia, National Early Warning Score (NEWS) score, and Charlson Comorbidity Index (CCI) were significant independent predictors of death. At multivariate Cox regression analysis, age, NEWS, pneumonia and CCI index were confirmed significant independent predictors of death. UDCA treatment was not a predictor of survival both in univariate and multivariate regressions.UDCA treatment does not appear to have significant effects on the outcome of COVID-19. Specially designed prospective studies are needed to evaluate efficacy in preventing infection and severe disease.CONCLUSIONSUDCA treatment does not appear to have significant effects on the outcome of COVID-19. Specially designed prospective studies are needed to evaluate efficacy in preventing infection and severe disease.
BackgroundUrsodeoxycholic acid (UDCA) has been recently proposed as a modulator of angiotensin‐converting enzyme 2 (ACE2) receptor expression, with potential effects on COVID‐19.Aim and Study DesignWe retrospectively evaluated the clinical course and outcome of subjects taking UDCA admitted to the hospital for COVID‐19 compared with matched infected subjects. Differences regarding the severity and outcome of the disease between treated and non‐treated subjects were assessed. The Kaplan–Meier survival analysis and log‐rank test were used to evaluate the effect of UDCA on all‐cause intra‐hospital mortality.ResultsAmong 6444 subjects with confirmed COVID‐19 admitted to the emergency department (ED) from 1 March 2020 to 31 December 2022, 109 subjects were taking UDCA. After matching 629 subjects were included in the study: 521 in the no UDCA group and 108 in the UDCA group. In our matched cohort, 144 subjects (22.9%) died, 118 (22.6%) in the no‐UDCA group and 26 (24.1%) in the UDCA group. The Kaplan–Meier analysis showed no significant difference in survival between groups. In univariate regression analysis, the presence of pneumonia, National Early Warning Score (NEWS) score, and Charlson Comorbidity Index (CCI) were significant independent predictors of death. At multivariate Cox regression analysis, age, NEWS, pneumonia and CCI index were confirmed significant independent predictors of death. UDCA treatment was not a predictor of survival both in univariate and multivariate regressions.ConclusionsUDCA treatment does not appear to have significant effects on the outcome of COVID‐19. Specially designed prospective studies are needed to evaluate efficacy in preventing infection and severe disease.
Author Novelli, Angela
Gasbarrini, Antonio
Covino, Marcello
Marrone, Giuseppe
Pompili, Maurizio
Merra, Giuseppe
Piccioni, Andrea
Amodeo, Annamaria
Murri, Rita
Franceschi, Francesco
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Keywords COVID-19
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UDCA
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2023 The Authors. Liver International published by John Wiley & Sons Ltd.
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Snippet Background Ursodeoxycholic acid (UDCA) has been recently proposed as a modulator of angiotensin‐converting enzyme 2 (ACE2) receptor expression, with potential...
Ursodeoxycholic acid (UDCA) has been recently proposed as a modulator of angiotensin-converting enzyme 2 (ACE2) receptor expression, with potential effects on...
BackgroundUrsodeoxycholic acid (UDCA) has been recently proposed as a modulator of angiotensin‐converting enzyme 2 (ACE2) receptor expression, with potential...
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crossref
wiley
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StartPage 83
SubjectTerms ACE2
Angiotensin
Angiotensin-converting enzyme 2
Comorbidity
COVID-19
Death
Emergency medical care
Health services
Hospitals
Multivariate analysis
Pneumonia
Rank tests
Regression analysis
SARS‐CoV‐2
Severe acute respiratory syndrome coronavirus 2
Survival
Survival analysis
UDCA
Ursodeoxycholic acid
Viral diseases
Title Ursodeoxycholic acid does not affect the clinical outcome of SARS‐CoV‐2 infection: A retrospective study of propensity score‐matched cohorts
URI https://onlinelibrary.wiley.com/doi/abs/10.1111%2Fliv.15736
https://www.ncbi.nlm.nih.gov/pubmed/37735968
https://www.proquest.com/docview/2903294579
https://www.proquest.com/docview/2868122360
Volume 44
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