Colchicine use might be associated with lower mortality in COVID‐19 patients: A meta‐analysis
Mohamed Nabil Elshafei, Ahmed El‐bardissy, Ahmed Khalil, Mohammed Danjuma, Mahmood Mubasher, Ibrahim Y Abubeker, Mouhand F H Mohamed
European Journal of Clinical Investigation, doi:10.1111/eci.13645
Background: Colchicine was recently repurposed for the management of coronavirus disease 2019 (COVID-19). This rapid review and meta-analysis aimed to assess colchicine's impact on mortality outcomes in COVID-19 patients. Materials and Methods: We systematically searched PubMed, EMBASE, Google Scholar since their inception till 25/03/2021 for observational or controlled studies that reported mortality as an outcome. The mortality odd ratios were generated with their corresponding 95% confidence intervals utilizing the random-effects model. Results: Nine studies comprising 5522 patients met our inclusion criteria. Our metaanalysis revealed significantly lower mortality in the colchicine group (OR 0.35, 95% CI 0.25-0.48, I2 0%) compared with controls. A subgroup analysis limited to hospitalized patients (OR 0.35, 95% CI 0.25-0.50, I2 0%) revealed similarly lower mortality in the colchicine group. Conclusions: This meta-analysis suggests a mortality benefit with colchicine when used in the treatment of COVID-19 patients. The majority of included studies were observational; thus, the findings of this review need to be further supported by the results of ongoing trials.
CONFLICT OF INTEREST None declared by all authors.
AUTHOR CONTRIBUTIONS
ETHICAL APPROVAL No ethical approval is necessary as this was a secondary synthesis of published articles.
References
Aimo, Figal, Bayes-Genis, Emdin, Georgiopoulos, Effect of low-dose colchicine in acute and chronic coronary syndromes: a systematic review and meta-analysis, Eur J Clin Invest,
doi:10.1111/eci.13464Brunetti, Diawara, Tsai, Colchicine to Weather the Cytokine Storm in Hospitalized Patients with COVID-19, J Clin Med,
doi:10.3390/jcm9092961Deftereos, Giannopoulos, Vrachatis, Effect of colchicine vs standard care on cardiac and inflammatory biomarkers and clinical outcomes in patients hospitalized with coronavirus disease 2019: the GRECCO-19 randomized clinical trial, JAMA Netw open,
doi:10.1001/jamanetworkopen.2020.13136Elshafei, Khalil, El-Bardissy, Danjuma, Ahmed et al., The efficacy of colchicine in the management of coronavirus disease 2019: A protocol for systematic review and meta-analysis, Medicine,
doi:10.1097/MD.0000000000021911García-Posada, Vesga, Mestra, Clinical outcomes of patients hospitalized for COVID-19 and evidence-based on the pharmacological management reduce mortality in a region of the Colombian Caribbean, J Infect Public Health,
doi:10.1016/j.jiph.2021.02.013Kimmig, Wu, Gold, IL-6 Inhibition in Critically Ill COVID-19 Patients Is Associated With Increased Secondary Infections, Front Med,
doi:10.3389/fmed.2020.583897Lopes, Bonjorno, Giannini, Beneficial effects of colchicine for moderate to severe COVID-19: a randomised, double-blinded, placebo-controlled clinical trial, RMD Open,
doi:10.1136/rmdopen-2020-001455Lopes, Bonjorno, Giannini, Beneficial effects of colchicine for moderate to severe COVID-19: a randomised, doubleblinded, placebo-controlled clinical trial, RMD Open,
doi:10.1136/rmdopen-2020-001455Mahale, Rajhans, Godavarthy, A Retrospective Observational Study of Hypoxic COVID-19 Patients Treated with Immunomodulatory Drugs in a Tertiary Care Hospital, Indian J Crit Care Med,
doi:10.5005/jp-journals-10071-23599Manenti, Maggiore, Fiaccadori, Reduced mortality in COVID-19 patients treated with colchicine: Results from a retrospective, observational study. Cannatà A, PLoS ONE,
doi:10.1371/journal.pone.0248276Mareev, Orlova, Plisyk, Proactive antiinflammatory therapy with colchicine in the treatment of advanced stages of new coronavirus infection. The first results of the COLORIT study, Kardiologiia,
doi:10.18087/cardio.2021.2.n1560Mohamed, Sd, Shunnar, Prevalence of Venous Thromboembolism in Critically Ill COVID-19 Patients: Systematic Review and Meta-Analysis, Front Cardiovasc Med,
doi:10.3389/fcvm.2020.598846Pinzón, Doris Cardona Arango, Betancur, Clinical Outcome of Patients with COVID-19
Sandhu, Tieng, Chilimuri, Franchin, A case control study to evaluate the impact of colchicine on patients admitted to the hospital with moderate to severe covid-19 infection, Can J Infect Dis Med Microbiol,
doi:10.1155/2020/8865954Scarsi, Piantoni, Colombo, 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, Ann Rheum Dis,
doi:10.1136/annrheumdis-2020-217712Wichmann, Sperhake, Lütgehetmann, Autopsy findings and venous thromboembolism in patients with COVID-19
