Can Ursodeoxycholic Acid Prevent Severe Acute Respiratory Syndrome Coronavirus 2 Infection or Reduce the Coronavirus Disease 2019 Severity? Current Knowledge and Unresolved Issues

A recent study revealed that the inhibition of the farnesoid X receptor using ursodeoxycholic acid (UDCA) significantly reduces angiotensin-converting enzyme 2 (ACE2) expression. Therefore, considerable attention has been paid to the use of UDCA to prevent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and reduce the severity of the disease. This review comprehensively summarizes the role of ACE2 in SARS-CoV-2 infection and the potential role and mechanisms of UDCA in the prevention of SARS-CoV-2 infection or reinfection. It also discusses unresolved issues and the potential use of UDCA in the treatment of patients with coronavirus disease.