Reduced mortality in COVID-19 patients treated with colchicine: Results from a retrospective, observational study

Abstract

Objectives Effective treatments for coronavirus disease 2019 (COVID-19) are urgently needed. We hypothesized that colchicine, by counteracting proinflammatory pathways implicated in the uncontrolled inflammatory response of COVID-19 patients, reduces pulmonary complications, and improves survival. Methods This retrospective study included 71 consecutive COVID-19 patients (hospitalized with pneumonia on CT scan or outpatients) who received colchicine and compared with 70 control patients who did not receive colchicine in two serial time periods at the same institution. We used inverse probability of treatment propensity-score weighting to examine differences in mortality, clinical improvement (using a 7-point ordinary scale), and inflammatory markers between the two groups. Results Amongst the 141 COVID-19 patients (118 [83.7%] hospitalized), 70 (50%) received colchicine. The 21-day crude cumulative mortality was 7.5% in the colchicine group and 28.5% in the control group (P = 0.006; adjusted hazard ratio: 0.24 [95%CI: 0.09 to 0.67]); 21-day clinical improvement occurred in 40.0% of the patients on colchicine and in 26.6% of control patients (adjusted relative improvement rate: 1.80 [95%CI: 1.00 to 3.22]). The strong association between the use of colchicine and reduced mortality was further supported by the diverging linear trends of percent daily change in lymphocyte count (P = 0.018), neutrophil-to-lymphocyte ratio (P = 0.003), and in C-reactive protein levels (P = 0.009). Colchicine was stopped because of transient side effects (diarrhea or skin rashes) in 7% of patients. Conclusion In this retrospective cohort study colchicine was associated with reduced mortality and accelerated recovery in COVID-19 patients. This support the rationale for current larger randomized controlled trials testing the safety/efficacy profile of colchicine in COVID-19 patients.

Colchicine use might be associated with lower mortality in COVID‐19 patients: A meta‐analysis

“…Three of the studies were randomized controlled trials 3 , 5 , 8 : one was quasi‐experimental, 9 and the remaining were observational. 2 , 6 , 10 , 11 , 12 The only included nonpeer‐reviewed publication by Tardif et al 8 accounted for the majority of included cases (4488 patients) and consisted of nonhospitalized patients. Patients in the intervention group received colchicine in different dosage regimens and were followed up to 30 days.…”

“…Our meta‐analysis revealed significantly lower mortality in the colchicine group (OR 0.35, 95% CI 0.25‐0.48, I 2 0%) (Figure 1 ). A subgroup analysis limited to 902 hospitalized patients of which 433 received colchicine (OR 0.35, 95% CI 0.25‐0.50, I 2 0%) 2 , 3 , 5 , 6 , 10 and to peer‐reviewed publications including total of 1034 patients (OR 0.33, 95% CI 0.24‐0.47, I 2 0%) 2 , 3 , 5 , 6 , 10 , 11 revealed similarly lower mortality in the colchicine group. The exclusion of constituent studies did not affect the results' consistency.…”

Review of studies on SARS-CoV-2 infection inhibitors

“…In total, 29 viral proteins have been identified, of which 25 are non-structural and four are structural [2]. The 16 non-structural proteins (NSPs) encoded by ORF1a/ ORF1ab form a replicase-transcriptase complex containing a number of enzymes, such as proteases, polymerases and endonucleases. The four structural proteins are the spike protein (S), a surface fusion protein consisting of two subunits S1 and S2; the nucleocapsid protein (N), the membrane protein (M), and the envelope protein (E).…”

“…In 7% of patients, colchicine treatment was discontinued due to severe adverse reactions, i.e. diarrhoea and skin rash [16].…”

Outpatient Management of COVID-19 Disease: A Holistic Patient-Centered Proposal Based on the Greek Experience

“…Regarding secondary endpoints, serious adverse events were reported equally among the colchicine and placebo group, pneumonia was more frequent in the placebo group and diarrhea was much more common in the colchicine group [ 52 ]. Positive results are shown in smaller retrospective studies in terms of time to recovery, serious adverse events, and biomarkers such as neutrophil to lymphocyte ratio [ 53 ].…”