Effect of ursodeoxycholic acid on symptoms after severe acute respiratory syndrome coronavirus 2 infection in patients with primary biliary cholangitis and their family members / 临床肝胆病杂志

ABSTRACT

ObjectiveTo investigate the effect of ursodeoxycholic acid （UDCA） on the symptoms after severe acute respiratory syndrome coronavirus 2 （SARS-CoV-2） infection in patients with primary biliary cholangitis （PBC） and their family member. MethodsA questionnaire survey was conducted to collect related information from 171 PBC patients who attended The First Affiliated Hospital of Air Force Medical University before March 22， 2023 and 128 family members， including demographic information， comorbidities， UDCA administration， SARS-CoV-2 infection， vaccination， symptoms， therapeutic medication， and the changes in liver disease-related symptoms. The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups， and the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. ResultsThe median age was 51 years in the PBC patients and 49 years in the family members， with no significant difference between the two groups （P>0.05）. Compared with the family member group， the PBC group had significantly lower body mass index （22.2±2.4 kg/m2 vs 23.3±2.9 kg/m2， P<0.001） and proportion of male individuals （10% vs 55%， P<0.001）. All PBC patients received UDCA at a dose of 13‍ ‍—‍ ‍15 mg/kg， and SARS-CoV-2 infection rate was 100% in both groups. The family members had a significantly higher SARS-CoV-2 vaccination rate than the PBC patients （91% vs 57%， P<0.001）. Compared with the family members， the PBC patients had significantly milder symptoms of sneezing， nasal obstruction， chest pain， and abnormal taste （P<0.05）. Compared with the family members， the PBC patients had significantly lower rates of use of compound cold medicine （11% vs 20%， P<0.05） and Lianhua Qingwen capsules （12% vs 21%， P<0.05）. For the PBC patients after SARS-CoV-2 infection， the liver disease-related symptoms such as fatigue， abdominal distension， dry mouth and dry eyes， pruritus， and yellow skin were aggravated by 37%， 2%， 27%， 10%， and 3%， respectively. ConclusionCompared with the immediate family members of PBC patients who do not take UDCA， the PBC patients receiving UDCA do not show a reduction in SARS-CoV-2 infection rate， but UDCA may have a certain effect on alleviating infection-related symptoms in such patients. PBC patients may still experience the aggravation of liver disease-related symptoms after SARS-CoV-2 infection， and the long-term effect on PBC patients after SARS-CoV-2 infection should be taken seriously in clinical practice.