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In Vitro Modeling of Fat Deposition in Metabolic Dysfunction-Associated Steatotic Liver Disease
07:03

In Vitro Modeling of Fat Deposition in Metabolic Dysfunction-Associated Steatotic Liver Disease

Published on: July 19, 2024

Ursodeoxycholic acid and long COVID in steatotic liver disease: a nationwide cohort study

Kyungyeon Jung1, Gi-Ae Kim2, Jieun Woo1

  • 1Department of Biohealth Regulatory Science, Sungkyunkwan University, Suwon, Korea.

Clinical and Molecular Hepatology
|June 9, 2026
PubMed

Insights

Ursodeoxycholic acid (UDCA) did not prevent most long COVID outcomes in patients with steatotic liver disease (SLD). While it showed a protective effect for atrial fibrillation, UDCA use was linked to increased risks of type 2 diabetes and epilepsy.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Cardiology
  • Endocrinology
  • Neurology

Background:

  • Ursodeoxycholic acid (UDCA) may reduce acute COVID-19 severity by downregulating the SARS-CoV-2 entry receptor ACE2.
  • Steatotic liver disease (SLD) patients are vulnerable to adverse COVID-19 outcomes, but UDCA's effect on long COVID in this group is unknown.

Purpose of the Study:

  • To investigate the association between pre-infection UDCA use and the risk of developing long COVID conditions in patients with SLD.

Main Methods:

  • Nationwide retrospective cohort study using Korean COVID-19 registry and National Health Insurance Service data (2019-2022).
  • Included patients with SLD (fatty liver index ≥30) who had COVID-19.
  • Assessed UDCA use within 90 days pre-infection and 20 long COVID outcomes ≥84 days post-infection.
  • Used propensity score fine stratification and Cox regression to estimate hazard ratios.

Main Results:

  • Among 469,108 SLD patients with COVID-19, 5.0% used UDCA.
  • UDCA use was not associated with reduced risk for most long COVID outcomes.
  • A protective association was found for atrial fibrillation (HR 0.51).
  • Increased risks were observed for type 2 diabetes mellitus (HR 1.24) and epilepsy (HR 1.69).

Conclusions:

  • Pre-infection UDCA use does not appear to reduce the risk of most long COVID outcomes in patients with SLD.
  • Observed associations require cautious interpretation due to potential residual confounding and surveillance bias.
Abstract

Keywords:
Angiotensin-converting enzyme 2Fatty liver diseaseLong COVIDPharmacoepidemiologyUrsodeoxycholic acid

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