Protective effect of ursodeoxycholic acid on COVID-19 in patients with chronic liver disease
ObjectiveUrsodeoxycholic acid (UDCA) may reduce susceptibility to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection by downregulating angiotensin-converting enzyme 2 (ACE2), based on recent experimental investigation. This study aimed to determine the potential protective effect...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-05-01
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| Series: | Frontiers in Cellular and Infection Microbiology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcimb.2023.1178590/full |
| _version_ | 1827955188490567680 |
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| author | Yanyan Li Na Zhu Xinyu Cui Yingying Lin Xin Li |
| author_facet | Yanyan Li Na Zhu Xinyu Cui Yingying Lin Xin Li |
| author_sort | Yanyan Li |
| collection | DOAJ |
| description | ObjectiveUrsodeoxycholic acid (UDCA) may reduce susceptibility to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection by downregulating angiotensin-converting enzyme 2 (ACE2), based on recent experimental investigation. This study aimed to determine the potential protective effect of UDCA against SARS-CoV-2 infection in patients with chronic liver disease.MethodsPatients with chronic liver disease receiving UDCA (taking UDCA ≥1 month) at Beijing Ditan Hospital between January 2022 and December 2022 were consecutively enrolled. These patients were matched in a 1:1 ratio to those with liver disease not receiving UDCA during the same period by using a propensity score matching analysis with nearest neighbor matching algorithm. We conducted a phone survey of coronavirus disease 2019 (COVID-19) infection during the early phase of the pandemic liberation (from 15 December 2022 to 15 January 2023). The risk of COVID-19 was compared in two matched cohorts of 225 UDCA users and 225 non-UDCA users based on patient self-report.ResultsIn the adjusted analysis, the control group was superior to the UDCA group in COVID-19 vaccination rates and liver function indicators, including γ-glutamyl transpeptidase and alkaline phosphatase (p < 0.05). UDCA was associated with a lower incidence of SARS-CoV-2 infection (UDCA 85.3% vs. control 94.2%, p = 0.002), more mild cases (80.0% vs. 72.0%, p = 0.047), and shorter median time from infection to recovery (5 vs. 7 days, p < 0.001). Logistic regression analysis showed that UDCA was a significant protective factor against COVID-19 infection (OR: 0.32, 95%CI: 0.16–0.64, p = 0.001). Furthermore, diabetes mellitus (OR: 2.48, 95%CI: 1.11–5.54, p = 0.027) and moderate/severe infection (OR: 8.94, 95%CI: 1.07–74.61, p = 0.043) were more likely to prolong the time from infection to recovery.ConclusionUDCA therapy may be beneficial in reducing COVID-19 infection risk, alleviating symptoms, and shortening the recovery time in patients with chronic liver disease. However, it should be emphasized that the conclusions were based on patient self-report rather than classical COVID-19 detection by experimental investigations. Further large clinical and experimental studies are needed to validate these findings. |
| first_indexed | 2024-04-09T14:41:56Z |
| format | Article |
| id | doaj.art-0d337e768c564bf08e770d2d72e8111b |
| institution | Directory Open Access Journal |
| issn | 2235-2988 |
| language | English |
| last_indexed | 2024-04-09T14:41:56Z |
| publishDate | 2023-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cellular and Infection Microbiology |
| spelling | doaj.art-0d337e768c564bf08e770d2d72e8111b2023-05-03T05:23:48ZengFrontiers Media S.A.Frontiers in Cellular and Infection Microbiology2235-29882023-05-011310.3389/fcimb.2023.11785901178590Protective effect of ursodeoxycholic acid on COVID-19 in patients with chronic liver diseaseYanyan Li0Na Zhu1Xinyu Cui2Yingying Lin3Xin Li4Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, ChinaCenter of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, ChinaCenter of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, ChinaCenter of Integrative Medicine, Peking University Ditan Teaching Hospital, Beijing, ChinaCenter of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, ChinaObjectiveUrsodeoxycholic acid (UDCA) may reduce susceptibility to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection by downregulating angiotensin-converting enzyme 2 (ACE2), based on recent experimental investigation. This study aimed to determine the potential protective effect of UDCA against SARS-CoV-2 infection in patients with chronic liver disease.MethodsPatients with chronic liver disease receiving UDCA (taking UDCA ≥1 month) at Beijing Ditan Hospital between January 2022 and December 2022 were consecutively enrolled. These patients were matched in a 1:1 ratio to those with liver disease not receiving UDCA during the same period by using a propensity score matching analysis with nearest neighbor matching algorithm. We conducted a phone survey of coronavirus disease 2019 (COVID-19) infection during the early phase of the pandemic liberation (from 15 December 2022 to 15 January 2023). The risk of COVID-19 was compared in two matched cohorts of 225 UDCA users and 225 non-UDCA users based on patient self-report.ResultsIn the adjusted analysis, the control group was superior to the UDCA group in COVID-19 vaccination rates and liver function indicators, including γ-glutamyl transpeptidase and alkaline phosphatase (p < 0.05). UDCA was associated with a lower incidence of SARS-CoV-2 infection (UDCA 85.3% vs. control 94.2%, p = 0.002), more mild cases (80.0% vs. 72.0%, p = 0.047), and shorter median time from infection to recovery (5 vs. 7 days, p < 0.001). Logistic regression analysis showed that UDCA was a significant protective factor against COVID-19 infection (OR: 0.32, 95%CI: 0.16–0.64, p = 0.001). Furthermore, diabetes mellitus (OR: 2.48, 95%CI: 1.11–5.54, p = 0.027) and moderate/severe infection (OR: 8.94, 95%CI: 1.07–74.61, p = 0.043) were more likely to prolong the time from infection to recovery.ConclusionUDCA therapy may be beneficial in reducing COVID-19 infection risk, alleviating symptoms, and shortening the recovery time in patients with chronic liver disease. However, it should be emphasized that the conclusions were based on patient self-report rather than classical COVID-19 detection by experimental investigations. Further large clinical and experimental studies are needed to validate these findings.https://www.frontiersin.org/articles/10.3389/fcimb.2023.1178590/fullcoronavirus disease 2019severe acute respiratory syndrome coronavirus-2ursodeoxycholic acidchronic liver diseaseinfectionpropensity score matching analysis |
| spellingShingle | Yanyan Li Na Zhu Xinyu Cui Yingying Lin Xin Li Protective effect of ursodeoxycholic acid on COVID-19 in patients with chronic liver disease Frontiers in Cellular and Infection Microbiology coronavirus disease 2019 severe acute respiratory syndrome coronavirus-2 ursodeoxycholic acid chronic liver disease infection propensity score matching analysis |
| title | Protective effect of ursodeoxycholic acid on COVID-19 in patients with chronic liver disease |
| title_full | Protective effect of ursodeoxycholic acid on COVID-19 in patients with chronic liver disease |
| title_fullStr | Protective effect of ursodeoxycholic acid on COVID-19 in patients with chronic liver disease |
| title_full_unstemmed | Protective effect of ursodeoxycholic acid on COVID-19 in patients with chronic liver disease |
| title_short | Protective effect of ursodeoxycholic acid on COVID-19 in patients with chronic liver disease |
| title_sort | protective effect of ursodeoxycholic acid on covid 19 in patients with chronic liver disease |
| topic | coronavirus disease 2019 severe acute respiratory syndrome coronavirus-2 ursodeoxycholic acid chronic liver disease infection propensity score matching analysis |
| url | https://www.frontiersin.org/articles/10.3389/fcimb.2023.1178590/full |
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