UDCA treatment against COVID-19: Do we have enough clinical evidence for drug repurposing?

Ursodeoxycholic acid (UDCA), an off-patent drug used to treat liver disease, is able to block SARS-CoV-2 entry into the cells downregulating ACE2 expression, a promising strategy to protect against infection. In this light, John et al. have recently demonstrated that in patients with cirrhosis, UDCA exposure was associated with both a decrease in SARS-CoV-2 infection and a reduction in COVID-19 severity confirming previous data published by Brevini et al. To investigate the impact of UDCA treatment in SARS-CoV-2 infection and COVID-19 outcomes in an unselected population of COVID-19 patients we used the administrative databases from Lombardy (Northern Italy), the first region of Western world to experience a rapid increase in the number of COVID-19 cases and related deaths and the most populated Italian region. The analysis included patients from the 1st and 2nd pandemic waves, were wild-type and alfa variant were predominant. This article is protected by copyright. All rights reserved.