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Ursodeoxycholic acid and severe COVID-19 outcomes

Ursodeoxycholic acid and severe COVID-19 outcomes in people with liver disease: a cohort study using the OpenSAFELY platform

How to cite: Ursodeoxycholic acid and severe COVID-19 outcomes in people with liver disease: a cohort study using the OpenSAFELY platform Ruth E Costello, Karen MJ Waller, Rachel Smith, George F Mells, Angel YS Wong, Anna Schultze, Viyaasan Mahalingasivam, Emily Herrett, Bang Zheng, Liang-Yu Lin, Amir Mehrkar, Sebastian CJ Bacon, Ben Goldacre, Laurie A Tomlinson, John Tazare, Christopher T. Rentsch medRxiv 2023.12.11.23299191; doi: https://doi.org/10.1101/2023.12.11.23299191

Abstract

Biological evidence suggests ursodeoxycholic acid (UDCA) - a common treatment of cholestatic liver disease - may prevent severe COVID-19 outcomes. With the approval of NHS England, we conducted a population-based cohort study using primary care records, linked to death registration data and hospital records through the OpenSAFELY-TPP platform. We estimated the hazard of COVID-19 hospitalisation or death between 1 March 2020 and 31 December 2022, comparing UDCA treatment to no UDCA treatment in a population with indication. Of 11,320 eligible individuals, 642 were hospitalised or died with COVID-19 during follow-up, 402 (63%) events among UDCA users. After confounder adjustment, UDCA was associated with a 21% (95% CI 7%-33%) relative reduction in the hazard of COVID-19 hospitalisation or death, consistent with an absolute risk reduction of 1.3% (95% CI 1.0%-1.6%). Our findings support calls for clinical trials investigating UDCA as a preventative measure for severe COVID-19 outcomes.