The role of
colchicine in the management of COVID-19: a Meta-analysis
Kholoud Elshiwy (1), Ghada Essam El-Din Amin (1,2), Mohamed
Nazmy Farres (3), Rasha Samir (3), Mohamed Farouk Allam (1,4)
1. Department of Family Medicine, Faculty of Medicine, Ain Shams
University, Cairo, Egypt.
2. Department of Community, Environmental and Occupational Medicine,
Faculty of Medicine, Ain Shams University, Cairo, Egypt.
3. Department of Internal Medicine, Faculty of Medicine, Ain Shams
University, Cairo, Egypt.
4. Department of Preventive Medicine and Public Health, Faculty of
Medicine, University of Cordoba, Cordoba, Spain.
BMC Pulmonary Medicine 2024 Apr 20;24(1):190.
DOI: 10.1186/s12890-024-03001-0
Abstract
Background: The Coronavirus disease
2019 (COVID-19) pandemic has robustly affected the global healthcare and
economic systems and it was caused by coronavirus-2 (SARS-CoV-2). The clinical
presentation of the disease ranges from a flu-like illness to severe pneumonia
and death. Till September 2022, the cumulative number of cases exceeded 600
million worldwide and deaths were more than 6 million. Colchicine is an
alkaloid drug that is used in many autoinflammatory conditions e.g., gout,
familial Mediterranean fever, and Behçet's syndrome. Colchicine inhibits the
production of superoxide and the release of interleukins that stimulate the
inflammatory cascade. Colchicine decreases the differentiation of myofibroblast
and the release of fibrotic mediators including transforming growth factor
(TGF-β1) that are related to the fibrosis. Moreover, colchicine has been used
to traet viral myocarditis caused by CMV or EBV, interstitial pneumonia, and
pericarditis resulting from influenza B infection. Additionally, colchicine is
considered safe and affordable with wide availability.
Objective: The aim of the current
study was to assess the evidence of colchicine effectiveness in COVID-19
treatment.
Methods: A comprehensive review
of the literature was done till May 2022 and yielded 814 articles after ranking
the articles according to authors and year of publication. Only 8 clinical
trials and cohort studies fulfilling the inclusion criteria were included for
further steps of data collection, analysis, and reporting.
Results: This meta-analysis
involved 16,488 patients; 8146 patients in the treatment group and 8342
patients in the control group. The results showed that colchicine resulted in a
significant reduction in the mortality rate among patients received colchicine
in comparison with placebo or standard care (RR 0.35, 95%CI: 0.15-0.79).
Colchicine resulted in a significant decrease in the need for O2 therapy in patients
with COVID-19 (RR 0.07, 95%CI 0.02-0.27, P = 0.000024). However, colchicine had
no significant effect on the following outcomes among COVID-19 patients: the
need for hospitalization, ICU admission, artificial ventilation, and hospital
discharge rate. Among the PCR confirmed COVID-19 patients, colchicine decreased
the hospitalization rate (RR 0.75, 95%CI 0.57-0.99, P = 0.042). However,
colchicine had no effect on mortality and the need for mechanical ventilation
among this subgroup.
Conclusion: Colchicine caused a
significant clinical improvement among COVID-19 patients as compared with the
standard care or placebo, in terms of the need for O2, and mortality. This
beneficial effect could play a role in the management of COVID-19 especially
severe cases to decrease need for oxygen and to decrease mortality among these
patients.
Keywords: Ain Shams University;
COVID-19; Colchicine; Coronavirus; Management; Meta-analysis; SARS-CoV-2.
Elshiwy K, Amin GEE,
Farres MN, Samir R, Allam MF. The role of colchicine in the management of
COVID-19: a Meta-analysis. BMC Pulm Med. 2024 Apr 20;24(1):190.
https://bmcpulmmed.biomedcentral.com/articles/10.1186/s12890-024-03001-0
