TY - JOUR AU - Lee, Hyunjun AU - Kim, Min Gul AU - Yeom, Sang Woo AU - Noh, Sang Jae AU - Jeong, Cho Yun AU - Kim, Min Ji AU - Kang, Min Gu AU - Ko, Ji Hoon AU - Park, Su Cheol AU - Kweon, Hyeok Tae AU - Sim, Sang Il AU - Lee, Hyun AU - You, Yeon Seok AU - Kim, Jong Seung PY - 2024 DA - 2024/10/7 TI - Association Between Ursodeoxycholic Acid and Clinical Outcomes in Patients With COVID-19 Infection: Population-Based Cohort Study JO - JMIR Public Health Surveill SP - e59274 VL - 10 KW - Covid 19 KW - COVID-19 KW - ursodeoxycholic acid KW - population-based cohort study KW - SARS-CoV-2 KW - Coronavirus KW - pandemic KW - population-based KW - retrospective cohort study KW - propensity score KW - UDCA KW - public health KW - common data model KW - clinical KW - severity AB - Background: Several studies have investigated the relationship between ursodeoxycholic acid (UDCA) and COVID-19 infection. However, complex and conflicting results have generated confusion in the application of these results. Objective: We aimed to investigate whether the association between UDCA and COVID-19 infection can also be demonstrated through the analysis of a large-scale cohort. Methods: This retrospective study used local and nationwide cohorts, namely, the Jeonbuk National University Hospital into the Observational Medical Outcomes Partnership common data model cohort (JBUH CDM) and the Korean National Health Insurance Service claim–based database (NHIS). We investigated UDCA intake and its relationship with COVID-19 susceptibility and severity using validated propensity score matching. Results: Regarding COVID-19 susceptibility, the adjusted hazard ratio (aHR) value of the UDCA intake was significantly lowered to 0.71 in the case of the JBUH CDM (95% CI 0.52-0.98) and was significantly lowered to 0.93 (95% CI 0.90-0.96) in the case of the NHIS. Regarding COVID-19 severity, the UDCA intake was found to be significantly lowered to 0.21 (95% CI 0.09-0.46) in the case of JBUH CDM. Furthermore, the aHR value was significantly lowered to 0.77 in the case of NHIS (95% CI 0.62-0.95). Conclusions: Using a large-scale local and nationwide cohort, we confirmed that UDCA intake was significantly associated with reductions in COVID-19 susceptibility and severity. These trends remained consistent regardless of the UDCA dosage. This suggests the potential of UDCA as a preventive and therapeutic agent for COVID-19 infection. SN - 2369-2960 UR - https://publichealth.jmir.org/2024/1/e59274 UR - https://doi.org/10.2196/59274 UR - http://www.ncbi.nlm.nih.gov/pubmed/39139026 DO - 10.2196/59274 ID - info:doi/10.2196/59274 ER -