Response to: ‘Correspondence on ‘Association between treatment with colchicine and improved survival in a single-centre cohort of adult hospitalised patients with COVID-19 pneumonia and acute respiratory distress syndrome’’ by Kawada

Abstract

Correspondence responsePatient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research. Patient consent for publication Not required. Ethics approvalThe off-label use of colchicine was supported by the hospital administration as the emergency situation of COVID-19, which was particularly severe in Lombardy with dozens of new patients on a daily basis, had to be managed quickly and amid shortage of 'Standard of Care' treatments such as antiviral drugs and hydroxychloroquine.Provenance and peer review Commissioned; internally peer reviewed. This article is made freely available for use in accordance with BMJ's website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

Colchicine for COVID-19: targeting NLRP3 inflammasome to blunt hyperinflammation

“…For all of these trials, the most common adverse event was diarrhea, especially among patients treated with colchicine, while no safety concerns with regard to infections were recorded. Several other observational studies reported encouraging results, with few, tolerable side effects [24,25,[27][28][29][89][90][91][92] (Table 2). Piantoni et al also reported about long-term results, describing an improved survival in patients treated with colchicine compared with standard-of-care (mortality rate at 270 days: 20% vs. 44%, p = 0.0001) [91].…”

Purinergic receptor ligands: the cytokine storm attenuators, potential therapeutic agents for the treatment of COVID-19

“…A meta-analysis demonstrated the efficacy of colchicine in COVID-19 management [ 128 ]. Accordingly, a better survival rate of patients with severe COVID-19 on colchicine therapy at the day of 8 compared to standard therapy has been reported, which is attributed to inhibition of central pro-inflammatory cytokines responsible for ARDS [ 129 ]. Furthermore, colchicine administration in COVID-19 patients on the fifth day of fever or after the 8th day of influenza-like symptoms initiation was recommended by Della-Torre et al.…”

Reports of three long‐term lung disease following SARS‐CoV‐2 infection

“…3 We have recently reevaluated, 6 months after Hospital discharge, 99 patients out of a series of 272 consecutively admitted to Esine Hospital for COVID19 pneumonia between March 5th and April 5th, 2020. 4 Considering patients who died in the meanwhile, 5 these represent the 54% of all the evaluable cohort. Notably, 6 months after discharge, 53% of these patients reported persistent dyspnea or cough.…”

“…Patients 1 and 2 were included in our original descriptions of Esine cohorts. 4,5 The first patient is a 48-year-old healthy man, admitted (16th March) for dyspnea, cough and fever, who developed SARS-CoV-2-pneumonia. He was treated with antivirals (darunavir/ ritonavir), hydroxychloroquine, high-flow oxygen in continuous positive airway pressure (C-PAP) mode.…”

“…Patient 1, T0: presence of 40% ground glass pneumonia, T3: presence of 70% ground glass pneumonia and septal thickening, T6: presence of honey combing; Patient 2, T0: presence of 35% ground glass pneumonia, T3: improving of ground glass and parenchyma bands, T6: presence of 35% ground glass pneumonia; Patient 3, T0: presence of 25% ground glass pneumonia, T3: not available, T6: presence of 20% ground glass pneumonia and parenchymal bands The frequency of this chronic lung damage after COVID-19 and its underlined mechanisms have yet to be clarified; clinical trial might be warranted to investigate the timing and the endurance of treatments to prevent it. Silvia Piantoni MD, PhD 1,2 Luisa Salada MD 3,4 Enrico Colombo MD 3,5 Monia Mendeni MD 3,5 Ezio Damiolini MD 3,4 Diego Gatta MD 3,4 Donata Richini MD 3,5 Roberto Furloni MD 3,5 Paolo Airò MD 1 Mirko Scarsi MD 3,5 1 Rheumatology and Clinical Immunology Unit, ASST Spedali Civili, Brescia, Italy…”