Evidence map›Paper›PMID 41993579›Full record

SynthesisFrontiers in pharmacology2026

Clinical effects of ursodeoxycholic acid in COVID-19 infection: a systematic review and dose-response meta-analysis.

Joo Hye Song, Sung Ryul Shim, Jieun Shin, Won Hyeok Choe, Jiho Park, Tae Hee Lee, Seonghui Kang, Taeho Greg Rhee, Kyu Chan Huh

Abstract readSystematic Review
In one paragraph

Synthesis in Frontiers in pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Joo Hye SongDivision of Gastroenterology, Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea.
Sung Ryul ShimDepartment of Biomedical Informatics, College of Medicine, Konyang University, Daejeon, Republic of Korea.
Jieun ShinDepartment of Biomedical Informatics, College of Medicine, Konyang University, Daejeon, Republic of Korea.
Won Hyeok ChoeDivision of Gastroenterology, Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea.
Jiho ParkDivision of Infectious Diseases, Department of Internal Medicine, Konkuk University of Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea.
Tae Hee LeeDivision of Gastroenterology, Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Republic of Korea.
Seonghui KangDivision of Infectious Diseases, Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Republic of Korea.
Taeho Greg RheeDepartment of Psychiatry, Yale University School of Medicine, New Haven, CT, United States.
Kyu Chan HuhDivision of Gastroenterology, Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Republic of Korea.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objectives: Previous studies have shown that ursodeoxycholic acid (UDCA) reduces COVID-19 infection by inhibiting farnesoid X receptor activity, a direct regulator of ACE2. Even though UDCA, an easily accessible medication with few side effects, could be considered for administration to prevent infection and relieve symptoms for COVID-19 infection, there are limited supporting studies with a high-level of evidence and recommendations for the exact dosage of UDCA. We conducted a systematic review and dose-response meta-analysis to evaluate the clinical effect of UDCA in COVID-19 infection. Methods: Studies were identified through a literature search: PubMed, Embase, and Cochrane from inception to March 2025. We included research related to COVID-19 infection and UDCA. Primary outcomes were COVID-19 infection rate, mortality rate, COVID-19 severe infection risk, ventilator use, hospitalization, ICU hospitalization, and recovery time between UDCA group and controls. The secondary outcome was UDCA dose-response association regarding infection risk. We analyzed for odds ratios (ORs), including infection rate, mortality rate, severe infection risk, ventilator use, hospitalization, and intensive care unit hospitalization, and for standardized mean difference (SMD), including recovery time between UDCA groups and controls. Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) was used to evaluate bias risk. Results: Of 188 articles, 15 cohort studies with 716,310 participants (control = 495,276; UDCA treatment = 221,034) were included. The level of risk of bias was seven studies at low, four at moderate, and four at serious. UDCA showed association with a lower risk of infection (OR, 0.69; 95% CI, 0.55-0.86), lower severe infection risk (OR, 0.75; 95% CI, 0.64-0.89), and ventilator use (OR, 0.75; 95% CI, 0.62-0.90) compared to controls. Conclusion: The findings support evidence for the clinical effects of UDCA for COVID-19 infection. There is a need for randomized trials to evaluate UDCA as a potential prophylactic agent against COVID-19. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251019195, identifier #CRD420251019195.

Indexed as

COVID-19dose responseinfectionmeta-analysisursodeoxycholic acid

Identifiers

PMID41993579
PMCPMC13079291

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.