Efficacy of Colchicine in the Treatment of COVID-19 Patients: A Systematic Review and Meta-Analysis

Abstract

Objective: We assessed the efficacy of colchicine in COVID-19 patients through a systematic review. Methods: Six databases were searched until March 2022 for studies assessing colchicine versus control in hospitalized patients with COVID-19. The primary outcome was mortality, and secondary outcome was length of hospitalization. Inverse variance and random effect meta-analyses were performed. The strength of evidence was assessed using GRADE. Results: Nine studies (five randomized clinical trials (RCTs) and four non-randomized studies of intervention (NRSI); n = 13,478). Colchicine did not reduce mortality in comparison with the standard of care in RCTs (RR 0.99; 95%CI 0.90 to 1.10; p = 0.90); however, it did reduce mortality in NRSI studies (RR 0.45; 95%CI 0.26 to 0.77; p = 0.02). In the analysis of RCTs, colchicine did not reduce the length of hospitalization in comparison with the standard of care (MD: −2.25 days; 95%CI: −9.34 to 4.84; p = 0.15). Most studies were scored as having a high risk of bias. Quality of evidence was very low for primary and secondary outcomes. Conclusion: Colchicine did not reduce the mortality and length of hospitalization in comparison with the standard of care in hospitalized patients with COVID-19. The published evidence is insufficient and of very low quality to recommend treatment in patients with COVID-19.

Colchicine reduces the activation of NLRP3 inflammasome in COVID-19 patients

“…The beneficial effects seemed to occur within the first 72 h, concurrently with a significant reduction in serum CRP. Although our and other groups have found beneficial effects of colchicine in COVID-19 patients, a greater number of studies failed to demonstrate a reduction in hospitalization, intensive care unit admission, or mortality, as reviewed in meta-analyses [9][10][11], which concluded that colchicine is not beneficial for treatment in outpatient and inpatient settings. Hence, colchicine is currently not indicated for COVID-19 [12][13][14].…”

“…The first studies evaluating the effect of colchicine on COVID-19 showed its utility in controlling systemic inflammation caused by SARS-CoV-2, resulting in shorter hospital stays and lower mortality [16]. Initial observations were followed by a greater number of studies, observational or controlled, in which this effect of colchicine was not confirmed by the majority [9][10][11]. Moreover, the two most prominent studies on colchicine for COVID-19, one recruiting outpatients [17] and the other recruiting inpatients [18], failed to demonstrate the efficacy of colchicine for their primary endpoints.…”

The Potential Role of Growth Differentiation Factor 15 in COVID-19: A Corollary Subjective Effect or Not?

“…A systematic review and meta-analysis by Yasmin et al [ 75 ] involved randomized clinical trials regarding the safety and effectiveness of colchicine in COVID-19 patients demonstrating that colchicine was effective and safe in the management of COVID-19. However, another systematic review illustrated that colchicine was infective in reducing mortality of hospitalized COVID-19 patients [ 76 ].…”

Colchicine Drug Interaction Errors and Misunderstandings: Recommendations for Improved Evidence-Based Management

“…Colchicine has a variety of off-label uses, including pericarditis, various dermatologic disorders, Behçet’s disease, and more recently it has been used to reduce cardiovascular events in patients with coronary artery disease [ 1 – 4 ]. Colchicine has also been tested in patients with COVID-19 in numerous clinical trials, but the results to date have been disappointing [ 5 , 6 ]. Colchicine is still under investigation for treatment of long COVID [ 7 ], and it can be used to treat the pericarditis that can occur in COVID patients [ 8 ].…”