Colchicine Treatment in SARS-CoV-2 Infection: A Systematic Review and Meta-Analysis

Beran, Azizullah; Mhanna, Mohammed; Wahood, Waseem; Ghazaleh, Sami; Sajdeya, Omar; Kalifa, Muhamad; Ayesh, Hazem; Srour, Omar; Mhanna, Asmaa; Altorok, Nezam; Assaly, Ragheb

doi:10.1097/mjt.0000000000001397

Cited by 4 publications

(3 citation statements)

References 15 publications

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“…A similar trend was observed in the sensitivity analysis. Although earlier meta-analysis performed by Chiu et al, 18 Vrachatis et al, 19 Hariyanto et al, 20 Salah et al, 21 Elshafei et al, 22 Golpour et al, 23 and Beran et al 24 concluded that colchicine may reduce the risk of mortality in patients with COVID-19 infection, we found no mortality benefit when adding colchicine to the usual care of hospitalized patients with this type of viral infection. The discrepancy with our results and with the recent meta-analysis performed by Kow et al 25 and Mehta et al 26 could be partially explained by the inclusion of only randomized clinical trials instead of a mixture of observational plus randomized studies.…”

Section: To the Editorcontrasting

confidence: 73%

The Effect of Colchicine on Mortality, Mechanical Ventilation, and Length of Stay in Patients With COVID-19 Infection: An Updated Systematic Review and Meta-analysis of Randomized Clinical Trials

Romeo

Barbagelata

Chiabrando

et al. 2022

American Journal of Therapeutics

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Section: To the Editorcontrasting

confidence: 73%

The Effect of Colchicine on Mortality, Mechanical Ventilation, and Length of Stay in Patients With COVID-19 Infection: An Updated Systematic Review and Meta-analysis of Randomized Clinical Trials

Romeo

Barbagelata

Chiabrando

et al. 2022

American Journal of Therapeutics

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“…To examine the effectiveness and safety of colchicine in a range of COVID-19 settings, several published meta-analyses have been carried out. The findings of Elshafei et al, Golpour et al, Beran et al, and Salah et al are consistent with each other since they all demonstrated a beneficial effect of colchicine use [ 11 , 13 , 57 , 58 ]. However, there are several issues with the analysis of these studies, as they employed both randomized and observational methods.…”

Section: Discussionsupporting

confidence: 57%

“…To examine the effectiveness and safety of colchicine in a range of COVID-19 settings, several published meta-analyses have been carried out. [11,13,57,58]. However, there are several issues with the analysis of these studies, as they employed both randomized and observational methods.…”

Section: Based On Our Systematic Review Analysismentioning

confidence: 99%

Oxygen Saturation in Hospitalized COVID-19 Patients and Its Relation to Colchicine Treatment: A Retrospective Cohort Study with an Updated Systematic Review

Sharaf¹,

Ashmawy²,

Saleh³

et al. 2023

Medicina

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Background: Colchicine has been proposed as a cytokine storm-blocking agent for COVID-19 due to its efficacy as an anti-inflammatory drug. The findings of the studies were contentious on the role of colchicine in preventing deterioration in COVID-19 patients. We aimed to evaluate the efficacy of colchicine in COVID-19-hospitalized patients. Design: A retrospective observational cohort study was carried out at three major isolation hospitals in Alexandria (Egypt), covering multiple centers. In addition, a systematic review was conducted by searching six different databases for published studies on the utilization of colchicine in patients with COVID-19 until March 2023. The primary outcome measure was to determine whether colchicine could decrease the number of days that the patient needed supplemental oxygen. The secondary outcomes were to evaluate whether colchicine could reduce the number of hospitalization days and mortality rate in these patients. Results: Out of 515 hospitalized COVID-19 patients, 411 were included in the survival analysis. After adjusting for the patients’ characteristics, patients not receiving colchicine had a shorter length of stay (median: 7.0 vs. 6.0 days) and fewer days of supplemental oxygen treatment (median: 6.0 vs. 5.0 days), p < 0.05, but there was no significant difference in mortality rate. In a subgroup analysis based on oxygen equipment at admission, patients admitted on nasal cannula/face masks who did not receive colchicine had a shorter duration on oxygen supply than those who did [Hazard Ratio (HR) = 0.76 (CI 0.59–0.97)]. Using cox-regression analysis, clarithromycin compared to azithromycin in colchicine-treated patients was associated with a higher risk of longer duration on oxygen supply [HR = 1.77 (CI 1.04–2.99)]. Furthermore, we summarized 36 published colchicine studies, including 114,878 COVID-19 patients. Conclusions: COVID-19-hospitalized patients who were given colchicine had poorer outcomes in terms of the duration of supplemental oxygen use and the length of their hospital stay. Therefore, based on these findings, the use of colchicine is not recommended for COVID-19-hospitalized adults.

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Mechanism of Caspase-1 Inhibition by Four Anti-inflammatory Drugs Used in COVID-19 Treatment

Caruso

Pedersen

Incerpi

et al. 2022

IJMS

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The inflammatory protease caspase-1 is associated with the release of cytokines. An excessive number of cytokines (a “cytokine storm”) is a dangerous consequence of COVID-19 infection and has been indicated as being among the causes of death by COVID-19. The anti-inflammatory drug colchicine (which is reported in the literature to be a caspase-1 inhibitor) and the corticosteroid drugs, dexamethasone and methylprednisolone, are among the most effective active compounds for COVID-19 treatment. The SERM raloxifene has also been used as a repurposed drug in COVID-19 therapy. In this study, inhibition of caspase-1 by these four compounds was analyzed using computational methods. Our aim was to see if the inhibition of caspase-1, an important biomolecule in the inflammatory response that triggers cytokine release, could shed light on how these drugs help to alleviate excessive cytokine production. We also measured the antioxidant activities of dexamethasone and colchicine when scavenging the superoxide radical using cyclic voltammetry methods. The experimental findings are associated with caspase-1 active site affinity towards these compounds. In evaluating our computational and experimental results, we here formulate a mechanism for caspase-1 inhibition by these drugs, which involves the active site amino acid Cys285 residue and is mediated by a transfer of protons, involving His237 and Ser339. It is proposed that the molecular moiety targeted by all of these drugs is a carbonyl group which establishes a S(Cys285)–C(carbonyl) covalent bond.

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Colchicine Treatment in SARS-CoV-2 Infection: A Systematic Review and Meta-Analysis

Abstract: therapeutic option for COVID-19. However, we need more large-scale clinical trials to better characterize the clinical benefits of colchicine in COVID-19.

Cited by 4 publications

References 15 publications

The Effect of Colchicine on Mortality, Mechanical Ventilation, and Length of Stay in Patients With COVID-19 Infection: An Updated Systematic Review and Meta-analysis of Randomized Clinical Trials

The Effect of Colchicine on Mortality, Mechanical Ventilation, and Length of Stay in Patients With COVID-19 Infection: An Updated Systematic Review and Meta-analysis of Randomized Clinical Trials

Oxygen Saturation in Hospitalized COVID-19 Patients and Its Relation to Colchicine Treatment: A Retrospective Cohort Study with an Updated Systematic Review

Mechanism of Caspase-1 Inhibition by Four Anti-inflammatory Drugs Used in COVID-19 Treatment

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