tetano
Editor, Senior Moderator
QJM
. 2023 Nov 9:hcad254.
doi: 10.1093/qjmed/hcad254. Online ahead of print. Effect of Ursodeoxycholic Acid on Preventing SARS-CoV-2 Infection in Patients With Liver Transplantation: a multicenter retrospective cohort study
Liangshuo Hu[SUP] 1 [/SUP], Huapeng Zhang[SUP] 2 [/SUP], Changjun Huang[SUP] 2 [/SUP], Tianli Shen[SUP] 3 [/SUP], Zhaozu Feng[SUP] 1 [/SUP], Fan Mu[SUP] 1 [/SUP], Lexuan Xu[SUP] 1 [/SUP], Yuyao Lin[SUP] 4 [/SUP], Chenyang Yue[SUP] 5 [/SUP], Kun Guo[SUP] 1 [/SUP], Min Tian[SUP] 1 [/SUP], Jianhua Shi[SUP] 1 [/SUP], Chun Zhang[SUP] 6 [/SUP], Peihao Wen[SUP] 2 [/SUP], Shengli Cao[SUP] 2 [/SUP], Yun Wang[SUP] 2 [/SUP], Jiakai Zhang[SUP] 2 [/SUP], Xiaoyi Shi[SUP] 2 [/SUP], Zhihui Wang[SUP] 2 [/SUP], Yuting He[SUP] 2 [/SUP], Xiaogang Zhang[SUP] 1 [/SUP], Xuemin Liu[SUP] 1 [/SUP], Yi Lv[SUP] 1 [/SUP], Zhengwen Liu[SUP] 7 [/SUP], Wenzhi Guo[SUP] 2 [/SUP], Bo Wang[SUP] 1 [/SUP]
Affiliations
Background: Immunosuppressed recipients of liver transplantation (LT) are more likely to develop coronavirus disease 2019 (COVID-19) and may have an increased risk of developing worse outcomes.
Aim: To assess the effect of ursodeoxycholic acid (UDCA) on preventing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in LT recipients.
Design: Adult patients (aged ≥ 18 years) who underwent LT between January 1st, 2015, and December 31st, 2022, were included and categorized into two groups according to their use of UDCA.
Methods: The prevalence and severity of COVID-19 among transplantation patients between the UDCA and non-UDCA groups were estimated and compared.
Results: Among the 897 LT patients who met the inclusion criteria, infection rate of SARS-CoV-2 was 78.4%, and the rate of severe illness was 5.1% from January 2022 to January 2023 in China. In the multivariate analysis, only UDCA treatment (P = 0.006) was found to be a protective factor against SARS-CoV-2 infection. After propensity score matching, the SARS-CoV-2 infection rate in the UDCA group was lower than that in the non-UDCA group (74.1% vs. 84.6%, P = 0.002). This rate was further reduced to 62.1% (P = 0.002) when the oral administration dose was greater than 15 mg/kg/d. There was no difference in the rates of severe COVID-19 illness, ICU admission, or ventilation rate or length of hospital stay with or without UDCA treatment (all P > 0.05).
Conclusions: The use of UDCA in LT patients significantly reduced the SARS-CoV-2 infection rate and showed a dose-dependent protective effect.
Keywords: Immunosuppress; Infection rate; Liver Transplantation; SARS-CoV-2; Ursodeoxycholic acid.
. 2023 Nov 9:hcad254.
doi: 10.1093/qjmed/hcad254. Online ahead of print. Effect of Ursodeoxycholic Acid on Preventing SARS-CoV-2 Infection in Patients With Liver Transplantation: a multicenter retrospective cohort study
Liangshuo Hu[SUP] 1 [/SUP], Huapeng Zhang[SUP] 2 [/SUP], Changjun Huang[SUP] 2 [/SUP], Tianli Shen[SUP] 3 [/SUP], Zhaozu Feng[SUP] 1 [/SUP], Fan Mu[SUP] 1 [/SUP], Lexuan Xu[SUP] 1 [/SUP], Yuyao Lin[SUP] 4 [/SUP], Chenyang Yue[SUP] 5 [/SUP], Kun Guo[SUP] 1 [/SUP], Min Tian[SUP] 1 [/SUP], Jianhua Shi[SUP] 1 [/SUP], Chun Zhang[SUP] 6 [/SUP], Peihao Wen[SUP] 2 [/SUP], Shengli Cao[SUP] 2 [/SUP], Yun Wang[SUP] 2 [/SUP], Jiakai Zhang[SUP] 2 [/SUP], Xiaoyi Shi[SUP] 2 [/SUP], Zhihui Wang[SUP] 2 [/SUP], Yuting He[SUP] 2 [/SUP], Xiaogang Zhang[SUP] 1 [/SUP], Xuemin Liu[SUP] 1 [/SUP], Yi Lv[SUP] 1 [/SUP], Zhengwen Liu[SUP] 7 [/SUP], Wenzhi Guo[SUP] 2 [/SUP], Bo Wang[SUP] 1 [/SUP]
Affiliations
- PMID: 37950449
- DOI: 10.1093/qjmed/hcad254
Background: Immunosuppressed recipients of liver transplantation (LT) are more likely to develop coronavirus disease 2019 (COVID-19) and may have an increased risk of developing worse outcomes.
Aim: To assess the effect of ursodeoxycholic acid (UDCA) on preventing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in LT recipients.
Design: Adult patients (aged ≥ 18 years) who underwent LT between January 1st, 2015, and December 31st, 2022, were included and categorized into two groups according to their use of UDCA.
Methods: The prevalence and severity of COVID-19 among transplantation patients between the UDCA and non-UDCA groups were estimated and compared.
Results: Among the 897 LT patients who met the inclusion criteria, infection rate of SARS-CoV-2 was 78.4%, and the rate of severe illness was 5.1% from January 2022 to January 2023 in China. In the multivariate analysis, only UDCA treatment (P = 0.006) was found to be a protective factor against SARS-CoV-2 infection. After propensity score matching, the SARS-CoV-2 infection rate in the UDCA group was lower than that in the non-UDCA group (74.1% vs. 84.6%, P = 0.002). This rate was further reduced to 62.1% (P = 0.002) when the oral administration dose was greater than 15 mg/kg/d. There was no difference in the rates of severe COVID-19 illness, ICU admission, or ventilation rate or length of hospital stay with or without UDCA treatment (all P > 0.05).
Conclusions: The use of UDCA in LT patients significantly reduced the SARS-CoV-2 infection rate and showed a dose-dependent protective effect.
Keywords: Immunosuppress; Infection rate; Liver Transplantation; SARS-CoV-2; Ursodeoxycholic acid.