Hu Tiantian, Tong Jie, Yang Yunhui, Yuan Changrong, Zhang Jiming, Wang Jinyu
Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China.
Fudan University School of Nursing, Fudan University, Shanghai, China.
Front Med (Lausanne). 2025 Feb 6;12:1494248. doi: 10.3389/fmed.2025.1494248. eCollection 2025.
The potential effect of ursodeoxycholic acid (UDCA) on the clinical outcomes of SARS-CoV-2 in patients with chronic liver diseases has been a subject of ongoing debate since the onset of the SARS-CoV-2 pandemic in 2019. This study aims to investigate the effect of UDCA on the prognosis of SARS-CoV-2 infection in patients with chronic liver diseases.
A total of 926 patients with chronic liver diseases who contracted their first SARS-CoV-2 infection during December 2022 to January 2023, were included in this study. Participants were divided into two groups based on the use of UDCA: the UDCA cohort ( = 329) and the non-UDCA cohort ( = 597). After performing a 1:1 age-and sex-matching, the analysis proceeded with 309 patients from each group for further evaluation.
In the UDCA-treated cohort, the incidence of asymptomatic SARS-CoV-2 infections was significantly higher, with 30.1% of patients affected, compared to 6.47% in the non-UDCA group ( < 0.0001). Multivariable analysis identified UDCA as a protective factor against symptomatic infections, yielding an odds ratio (OR) of 4.77 (95% CI: 2.70-8.44, < 0.001). Furthermore, age over 50 was found to be a risk factor for asymptomatic infections in the UDCA cohort, with an adjusted OR of 1.51 (95% CI: 1.01-2.24, = 0.05).
The study suggests that UDCA therapy may improve clinical outcomes in patients with chronic liver diseases patients who are infected with SARS-CoV-2, highlighting its potential role in improving prognosis within this vulnerable population. However, further research is required to validate these findings and to elucidate the mechanisms underlying UDCA's protective effect.
自2019年新型冠状病毒肺炎疫情爆发以来，熊去氧胆酸（UDCA）对慢性肝病患者感染新型冠状病毒2（SARS-CoV-2）临床结局的潜在影响一直是持续争论的话题。本研究旨在探讨UDCA对慢性肝病患者感染SARS-CoV-2预后的影响。
本研究纳入了2022年12月至2023年1月期间首次感染SARS-CoV-2的926例慢性肝病患者。根据是否使用UDCA将参与者分为两组：UDCA队列（n = 329）和非UDCA队列（n = 597）。在进行1:1年龄和性别匹配后，对每组309例患者进行分析以进行进一步评估。
在接受UDCA治疗的队列中，无症状SARS-CoV-2感染的发生率显著更高，有30.1%的患者受影响，而非UDCA组为6.47%（P < 0.0001）。多变量分析确定UDCA是预防有症状感染的保护因素，优势比（OR）为4.77（95%置信区间：2.70 - 8.44，P < 0.001）。此外，发现50岁以上是UDCA队列中无症状感染的危险因素，调整后的OR为1.51（95%置信区间：1.01 - 2.24，P = 0.05）。
该研究表明，UDCA治疗可能改善感染SARS-CoV-2的慢性肝病患者的临床结局，突出了其在改善这一脆弱人群预后方面的潜在作用。然而，需要进一步研究来验证这些发现并阐明UDCA保护作用的潜在机制。
