Colchicine treatment can improve outcomes of coronavirus disease 2019 (COVID‐19): A systematic review and meta‐analysis

Hariyanto, Timotius Ivan; Halim, Devina Adella; Jodhinata, Claudia; Yanto, Theo Audi; Kurniawan, Andree

doi:10.1111/1440-1681.13488

Cited by 62 publications

(48 citation statements)

References 27 publications

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“…Recent RCTs in patients with coronary artery disease have shown significant reduction of CVD events with colchicine treatment [145]. A metaanalysis of eight studies included 5778 COVID-19 patients and 2668 patients who received colchicine treatment [146]. Of the eight studies, three were RCTs, two and two retrospective and prospective cohort studies, respectively, and the remaining one was a case-control study.…”

Section: Non-steroidal Anti-inflammatory Drugs (Nsaids) Including Colchicinementioning

confidence: 99%

“…In the pooled analysis colchicine was associated with improvement in outcomes of COVID‐19 by 57%, and a reduction of mortality also by 57%. The reduction of outcomes was somewhat smaller (49%) in RCTs than in observational studies (59%), but still significant [ 146 ]. In January 2021, the Montreal Heart Institute announced that in the large, international COLCORONA clinical trial with non-hospitalised patients, colchicine, as compared to placebo, has reduced hospitalisations significantly by 25%, the need for mechanical ventilation or deaths nonsignificantly by 50% and 44%, respectively, among 4159 patients in whom the diagnosis of COVID-19 was proven by a naso-pharyngeal PCR test [ 147 ].…”

Section: Non-steroidal Anti-inflammatory Drugs (Nsaids) Including Colchicinementioning

confidence: 99%

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Protecting older patients with cardiovascular diseases from COVID-19 complications using current medications

et al. 2021

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Purpose In the pathogenesis of severe COVID-19 complications, derangements of renin–angiotensin–aldosterone system (RAAS), vascular endothelial dysfunction leading to inflammation and coagulopathy, and arrhythmias play an important role. Therefore, it is worth considering the use of currently available drugs to protect COVID-19 patients with cardiovascular diseases. Methods We review the current experience of conventional cardiovascular drugs [angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers, anticoagulants, acetosalicylic acid, antiarrhythmic drugs, statins] as well as some other drug classes (antidiabetic drugs, vitamin D and NSAIDs) frequently used by older patients with cardiovascular diseases. Data were sought from clinical databases for COVID-19 and appropriate key words. Conclusions and recommendations are based on a consensus among all authors. Results Several cardiovascular drugs have a potential to protect patients with COVID-19, although evidence is largely based on retrospective, observational studies. Despite propensity score adjustments used in many analyses observational studies are not equivalent to randomised controlled trials (RCTs). Ongoing RCTs include treatment with antithrombotics, pulmonary vasodilators, RAAS-related drugs, and colchicine. RCTs in the acute phase of COVID-19 may not, however, recognise the benefits of long term anti-atherogenic therapies, such as statins. Conclusions Most current cardiovascular drugs can be safely continued during COVID-19. Some drug classes may even be protective. Age-specific data are scarce, though, and conditions which are common in older patients (frailty, comorbidities, polypharmacy) must be individually considered for each drug group.

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Section: Non-steroidal Anti-inflammatory Drugs (Nsaids) Including Colchicinementioning

confidence: 99%

Section: Non-steroidal Anti-inflammatory Drugs (Nsaids) Including Colchicinementioning

confidence: 99%

Protecting older patients with cardiovascular diseases from COVID-19 complications using current medications

et al. 2021

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“…Reduced lung injury by colchicine use has been reported in rats with acute respiratory syndrome [ 14 ]. During the pandemic, colchicine treatment is associated with better outcomes in previous studies [ 15 ]. However, not all studies have the same finding [ 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

Repurposing Colchicine in Treating Patients with COVID-19: A Systematic Review and Meta-Analysis

Lien

Lee

Weng

et al. 2021

Life

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Coronavirus disease 2019 (COVID-19) had caused huge health losses worldwide. Several drugs had been applied to treat patients with COVID-19, and repurposing colchicine had been proposed for its anti-inflammatory properties via several pathways. In this systematic review, we evaluated the effects of colchicine treatment. From inception to May 31, 2021, databases, including PubMed, EMbase, medRxiv, and Research Square were searched, and 11 studies were enrolled. A total of 17,205 COVID-19 patients with male predominance (62.9%) were analyzed. Patients with colchicine treatment had a significantly lower risk of mortality (odds ratio (OR): 0.57, 95% confidence interval (CI): 0.38–0.87, I2: 72%; p < 0.01) and a non-significantly lower rate of mechanical ventilation (OR: 0.67, 95%CI: 0.39–1.15). The side effects were mild and not significantly different (OR: 2.03, 95%CI: 0.51–8.09). Subgroup analysis with randomized controlled trials showed no statistically significant difference in the mortality (OR: 0.80, 95%CI: 0.44–1.46, I2: 33%; p = 0.22). In conclusion, our meta-analysis found that colchicine treatment was associated with a significantly lower risk of mortality in patients with COVID-19. However, this benefit was not observed in the subgroup analysis of randomized controlled trials. Further randomized controlled studies are required to confirm the potential benefits of colchicine treatment.

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“…Given the central role of cytokine storm in the progression of severe COVID-19 cases, suppressing this immune response may be an opportunity to intervene. As such, several immunomodulatory treatments (including corticosteroids, Janus kinase (JAK) inhibitors, hydroxychloroquine, Tocilizumab and Colchicine) as well as antivirals like remdesivir and lopinavir/ritonavir have been proposed, but results have been mixed [ [10] , [11] , [12] , [13] , [14] ]. To date, only tocilizumab and dexamethasone have been shown to reduce mortality in severe COVID-19, while baricitinibe (a JAK inhibitor) is combination with remdesivir reduces recovery time [ [15] , [16] , [17] ].…”

Section: Introductionmentioning

confidence: 99%

“…To date, only tocilizumab and dexamethasone have been shown to reduce mortality in severe COVID-19, while baricitinibe (a JAK inhibitor) is combination with remdesivir reduces recovery time [ [15] , [16] , [17] ]. Despite advances in treatment approach, severe COVID-19 remains challenging to treat and additional effective interventions are needed [ [10] , [11] , [12] , [13] , [14] ].…”

Section: Introductionmentioning

confidence: 99%

A systematic review on the effects of Echinacea supplementation on cytokine levels: Is there a role in COVID-19?

et al. 2021

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COVID-19 is the respiratory illness caused by the novel coronavirus, SARS-CoV-2. Cytokine storm appears to be a factor in COVID-19 mortality. Echinacea species have been used historically for immune modulation. A previous rapid review suggested that Echinacea supplementation may decrease the levels of pro-inflammatory cytokines involved in cytokine storm. The objective of the present systematic review was to identify all research that has assessed changes in levels of cytokines relevant to cytokine storm in response to administration of Echinacea supplementation. The following databases were searched: Medline (Ovid), AMED (Ovid), CINAHL (EBSCO), EMBASE (Ovid). Title and abstract screening, full text screening, and data extraction were completed in duplicate using a piloted extraction template. Risk of bias assessment was completed. Qualitative analysis was used to assess for trends in cytokine level changes. The search identified 279 unique publications. After full text screening, 105 studies met criteria for inclusion including 13 human studies, 24 animal studies, and 71 in vitro or ex vivo studies. The data suggest that Echinacea supplementation may be associated with a decrease in the pro-inflammatory cytokines IL-6, IL-8, and TNF, as well as an increase in the anti-inflammatory cytokine IL-10. The risk of bias in the included studies was generally high. While there is currently no substantive research on the therapeutic effects of Echinacea in the management of either cytokine storm or COVID-19, the present evidence related to the herb's impact on cytokine levels suggests that further research may be warranted in the form of a clinical trial involving patients with COVID-19.

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Colchicine treatment can improve outcomes of coronavirus disease 2019 (COVID‐19): A systematic review and meta‐analysis

Cited by 62 publications

References 27 publications

Protecting older patients with cardiovascular diseases from COVID-19 complications using current medications

Protecting older patients with cardiovascular diseases from COVID-19 complications using current medications

Repurposing Colchicine in Treating Patients with COVID-19: A Systematic Review and Meta-Analysis

A systematic review on the effects of Echinacea supplementation on cytokine levels: Is there a role in COVID-19?

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