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.

Read the full paper → OpenSAFELY Approved Project #145 View the code repository

Paper information

Authors
  • 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
Citation
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
DOI
10.1101/2023.12.11.23299191
Categories

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.