在使用OpenSAFELY平台进行的一项队列研究中,乌尔索西胆酸和严重的COVID-19结果
Ruth E Costello1, Karen M J Waller2,3,4, Rachel Smith5
1London School of Hygiene and Tropical Medicine, London, UK. ruth.costello@lshtm.ac.uk.
Communications medicine
|November 20, 2024
概括
Ursodeoxycholic 酸 (UDCA) 是一种治疗胆固醇性肝病的药物,可以减轻严重的COVID-19. 这项研究发现,UDCA的使用与COVID-19住院或死亡的风险降低了21%,这些患者患有原发性胆道胆炎或原发性硬化胆炎.
科学领域:
- 肝病学和传染病研究研究.
- 临床流行病学 临床流行病学
- 病毒病的药理预防 病毒病的药理预防
背景情况:
- 乌尔索多胆酸 (UDCA) 是一种常见的治疗方法,用于治疗胆固醇性肝脏疾病,如原发性胆道胆炎 (PBC) 和原发性硬化胆炎 (PSC).
- 新兴的生物证据表明,UDCA可能具有有利于预防COVID-19严重后果的特性.
- 这项研究调查了UDCA在患有特定胆固醇性肝病症的患者中对严重的COVID-19的潜在保护作用.
研究的目的:
- 为了比较使用UDCA和不使用UDCA的人之间的COVID-19住院或死亡风险.
- 评估UDCA暴露与患有PBC或PSC的人群中严重的COVID-19结果之间的关联.
- 提供支持或反驳UDCA作为重症COVID-19预防措施的证据.
主要方法:
- 一项基于人口的队列研究,利用2020年3月至2022年12月的英国初级保健记录.
- 通过OpenSAFELY-TPP平台与死亡登记和医院记录进行数据链接.
- 考克斯比例危险回归分析以估计COVID-19相关住院或死亡的危险比率,调整混因素.
主要成果:
- 该研究包括11,305人,其中640人经历了COVID-19住院治疗或死亡.
- 在调整了混因素后,UDCA使用与21%的COVID-19住院或死亡风险相对降低有关 (HR 0.79,95%CI 0.67-0.93).
- 这相当于对严重的COVID-19结局的绝对风险降低1.35% (95%CI1.07%-1.69%).
结论:
- 有证据表明,UDCA与PBC或PSC患者的COVID-19住院和死亡风险降低有关.
- 这些发现支持需要进行临床试验,以调查UDCA作为严重COVID-19的潜在预防策略.
- UDCA可能代表了一种新的治疗途径,用于减轻严重的COVID-19并发症.
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