- Status:
- Preprint
- Posted:
Ursodeoxycholic acid and severe COVID-19 outcomes in people with liver disease
Cohort study investigating whether ursodeoxycholic acid was associated with COVID-19 related hospitalisation and death in people with primary biliary cirrhosis and primary sclerosing cholangitis.
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.
- Ruth Costello,
- Karen Waller,
- Rachel Smith,
- George Mells,
- Angel Wong,
- Anna Schultze,
- Viyaasan Mahalingasivam,
- Emily Herrett,
- Bang Zheng,
- Liang-Yu Lin,
- Amir Mehrkar,
- Seb Bacon,
- Ben Goldacre,
- Laurie Tomlinson,
- John Tazare,
- Christopher Rentsch