Ursodeoxycholic acid and severe COVID-19 outcomes in a cohort study using the OpenSAFELY platform
Year: 2024
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Biological evidence suggests ursodeoxycholic acid (UDCA)-a common treatment of cholestatic liver disease-may prevent severe COVID-19 outcomes. We aimed to compare the hazard of COVID-19 hospitalisation or death between UDCA users versus non-users in a population with primary biliary cholangitis (PBC) or primary sclerosing cholangitis (PSC). METHODS: With the approval of NHS England, we conducted a population-based cohort study using primary care records between 1 March 2020 and 31 December 2022, linked to death registration data and hospital records through the OpenSAFELY-TPP platform. Cox proportional hazards regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association between time-varying UDCA exposure and COVID-19 related hospitalisation or death, stratified by geographical region and considering models unadjusted and fully adjusted for pre-specified confounders. RESULTS: We identify 11,305 eligible individuals, 640 were hospitalised or died with COVID-19 during follow-up, 400 (63%) events among UDCA users. After confounder adjustment, UDCA is associated with a 21% relative reduction in the hazard of COVID-19 hospitalisation or death (HR 0.79, 95% CI 0.67-0.93), consistent with an absolute risk reduction of 1.35% (95% CI 1.07%-1.69%). CONCLUSIONS: We found evidence that UDCA is associated with a lower hazard of COVID-19 related hospitalisation and death, support calls for clinical trials investigating UDCA as a preventative measure for severe COVID-19 outcomes.
Source: Communications Medicine
Authors: Ruth E. Costello, Karen M. J. Waller, Rachel Smith, George F. Mells, Angel Y. S. Wong, Anna Schultze, Viyaasan Mahalingasivam, Emily Herrett, Bang Zheng, Liang-Yu Lin, Brian MacKenna, Amir Mehrkar, Sebastian C. J. Bacon, Ben Goldacre, Laurie A. Tomlinson, John Tazare, Christopher T. Rentsch, the OpenSAFELY collaborative, the LH&W NCS (or CONVALESCENCE) Collaborative
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,490
Awards: The OpenSafely Research Platform, G2123105393, OpenSAFELY, ISARIC, PHOSP: tracking consequences of COVID-19 infection across UK primary and secondary care., G2558559306, G3983572576, The OpenSafely Research Platform, Quality-of-life in patients with long COVID: harnessing the scale of big data to quantify the health and economic costs, G4069887101, COVID-19 survivors and kidney disease: The long term effects on kidney function, and health outcomes for people with pre-existing chronic kidney disease - a study using electronic health records, Urgent research and surveillance on Covid-19 using the new OpenSAFELY secure platform across 55 million patients' full linked primary care records, G4782868754, Community deployment of monoclonal antibody treatment for treatment of COVID, Characterisation, determinants, mechanisms and consequences of the long-term effects of COVID-19: providing the evidence base for health care services, G5323192444, G5509661070, INTEGRATE: Using routinely-collected healthcare data to inform clinical guidance and improve population health, G6526062327, G6781659469
OpenAlex ID: W4404513888