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All Studies   Meta Analysis    Recent:   

The role of colchicine in the management of COVID-19: a meta-analysis

Elshiwy et al., BMC Pulmonary Medicine, doi:10.1186/s12890-024-03001-0
Apr 2024  
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Mortality 65% Improvement Relative Risk Ventilation 60% ICU admission 71% Oxygen therapy 93% Colchicine for COVID-19  Elshiwy et al.  META ANALYSIS c19early.org Favorscolchicine Favorscontrol 0 0.5 1 1.5 2+
Colchicine for COVID-19
5th treatment shown to reduce risk in September 2020
 
*, now with p = 0.00000031 from 56 studies.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,800+ studies for 98 treatments. c19early.org
Systematic review and meta-analysis of 8 studies (4 RCTs) involving 16,488 COVID-19 patients showed significantly lower mortality and need for oxygen therapy with colchicine.
10 meta analyses show significant improvements with colchicine for mortality1-8, oxygen therapy8, hospitalization9, and severity10.
Currently there are 56 colchicine for COVID-19 studies, showing 28% lower mortality [17‑37%], 29% lower ventilation [-15‑56%], 34% lower ICU admission [8‑52%], 19% lower hospitalization [11‑26%], and 9% more cases [-8‑29%].
risk of death, 65.0% lower, RR 0.35, p = 0.01.
risk of mechanical ventilation, 60.0% lower, RR 0.40, p = 0.09.
risk of ICU admission, 71.0% lower, RR 0.29, p = 0.08.
risk of oxygen therapy, 93.0% lower, RR 0.07, p < 0.001.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Elshiwy et al., 20 Apr 2024, peer-reviewed, 5 authors. Contact: kholoud.elshiwy@med.asu.edu.eg.
This PaperColchicineAll
The role of colchicine in the management of COVID-19: a Meta-analysis
Kholoud Elshiwy, Ghada Essam El-Din Amin, Mohamed Nazmy Farres, Rasha Samir, Mohamed Farouk Allam
BMC Pulmonary Medicine, doi:10.1186/s12890-024-03001-0
Background The Coronavirus disease 2019 (COVID-19) pandemic has robustly affected the global healthcare and economic systems and it was caused by coronavirus-2 (SARS-CoV-2). The clinical presentation of the disease ranges from a flu-like illness to severe pneumonia and death. Till September 2022, the cumulative number of cases exceeded 600 million worldwide and deaths were more than 6 million. Colchicine is an alkaloid drug that is used in many autoinflammatory conditions e.g., gout, familial Mediterranean fever, and Behçet's syndrome. Colchicine inhibits the production of superoxide and the release of interleukins that stimulate the inflammatory cascade. Colchicine decreases the differentiation of myofibroblast and the release of fibrotic mediators including transforming growth factor (TGF-β1) that are related to the fibrosis. Moreover, colchicine has been used to traet viral myocarditis caused by CMV or EBV, interstitial pneumonia, and pericarditis resulting from influenza B infection. Additionally, colchicine is considered safe and affordable with wide availability. Objective The aim of the current study was to assess the evidence of colchicine effectiveness in COVID-19 treatment. Methods A comprehensive review of the literature was done till May 2022 and yielded 814 articles after ranking the articles according to authors and year of publication. Only 8 clinical trials and cohort studies fulfilling the inclusion criteria were included for further steps of data collection, analysis, and reporting. Results This meta-analysis involved 16,488 patients; 8146 patients in the treatment group and 8342 patients in the control group. The results showed that colchicine resulted in a significant reduction in the mortality rate among patients received colchicine in comparison with placebo or standard care (RR 0.35, 95%CI: 0.15-0.79). Colchicine resulted in a significant decrease in the need for O2 therapy in patients with COVID-19 (RR 0.07, 95%CI 0.02-0.27, P = 0.000024). However, colchicine had no significant effect on the following outcomes among COVID-19 patients: the need for hospitalization, ICU admission, artificial ventilation, and hospital discharge rate. Among the PCR confirmed COVID-19 patients, colchicine decreased the hospitalization rate (RR 0.75, 95%CI 0.57-0.99, P = 0.042). However, colchicine had no effect on mortality and the need for mechanical ventilation among this subgroup. Conclusion Colchicine caused a significant clinical improvement among COVID-19 patients as compared with the standard care or placebo, in terms of the need for O2, and mortality. This beneficial effect could play a role in the management of COVID-19 especially severe cases to decrease need for oxygen and to decrease mortality among these patients.
Authors' contributions Kholoud Elshiwy: Field work supervision, analysis strategy and design, data management, data analysis and interpretation of results, decision making on content and paper write-up and revision of final draft. Ghada Essam El-Din Amin: Field work supervision, analysis strategy and design, data management, data analysis and interpretation of results, decision making on content and paper write-up and revision of final draft. Mohamed Nazmy: Field work supervision, analysis strategy and design, data management, data analysis and Declarations Ethics approval and consent to participate Not applicable. Consent for publication Not applicable. Competing interests The authors declare no competing interests. Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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' '2021;7(1):1–8.', 'journal-title': 'RMD Open.'}, { 'key': '3001_CR24', 'doi-asserted-by': 'publisher', 'first-page': '1', 'DOI': '10.1155/2020/8865954', 'volume': '2020', 'author': 'T Sandhu', 'year': '2020', 'unstructured': 'Sandhu T, Tieng A, Chilimuri S, Franchin G. 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. 2020;2020:1–9.', 'journal-title': 'Can J Infect Dis Med Microbiol.'}, { 'issue': '2', 'key': '3001_CR25', 'doi-asserted-by': 'publisher', 'first-page': '15', 'DOI': '10.18087/cardio.2021.2.n1560', 'volume': '61', 'author': 'VY Mareev', 'year': '2021', 'unstructured': 'Mareev VY, Orlova YA, Plisyk AG, et al. Proactive anti-inflammatory ' 'therapy with colchicine in the treatment of advanced stages of new ' 'coronavirus infection. The first results of the COLORIT study. ' 'Kardiologiya. 2021;61(2):15–27.', 'journal-title': 'Kardiologiya.'}, { 'issue': '9', 'key': '3001_CR26', 'doi-asserted-by': 'publisher', 'first-page': '1', 'DOI': '10.3390/jcm9092961', 'volume': '9', 'author': 'L Brunetti', 'year': '2020', 'unstructured': 'Brunetti L, Diawara O, Tsai A, et al. Colchicine to weather the cytokine ' 'storm in hospitalized patients with COVID-19. J Clin Med. ' '2020;9(9):1–12.', 'journal-title': 'J Clin Med.'}, { 'issue': '10', 'key': '3001_CR27', 'doi-asserted-by': 'publisher', 'first-page': '1286', 'DOI': '10.1136/annrheumdis-2020-217712', 'volume': '79', 'author': 'M Scarsi', 'year': '2020', 'unstructured': 'Scarsi M, Piantoni S, Colombo E, et al. 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. 2020;79(10):1286–9.', 'journal-title': 'Ann Rheum Dis.'}, { 'issue': '1', 'key': '3001_CR28', 'doi-asserted-by': 'publisher', 'first-page': '775', 'DOI': '10.1080/07853890.2021.1993327', 'volume': '54', 'author': 'D Sanghavi', 'year': '2022', 'unstructured': 'Sanghavi D, Bansal P, Kaur IP, et al. Impact of colchicine on mortality ' 'and morbidity in COVID-19: a systematic review. Ann Med. ' '2022;54(1):775–89.', 'journal-title': 'Ann Med.'}, { 'issue': '9', 'key': '3001_CR29', 'doi-asserted-by': 'publisher', 'first-page': '1', 'DOI': '10.1111/eci.13645', 'volume': '51', 'author': 'MN Elshafei', 'year': '2021', 'unstructured': 'Elshafei MN, El-Bardissy A, Khalil A, et al. Colchicine use might be ' 'associated with lower mortality in COVID-19 patients: a meta-analysis. ' 'Eur J Clin Investig. 2021;51(9):1–5.', 'journal-title': 'Eur J Clin Investig.'}, { 'issue': '3', 'key': '3001_CR30', 'doi-asserted-by': 'publisher', 'first-page': '1', 'DOI': '10.1136/rmdopen-2021-001746', 'volume': '7', 'author': 'KG Mehta', 'year': '2021', 'unstructured': 'Mehta KG, Patel T, Chavda PD, et al. Efficacy and safety of colchicine ' 'in COVID-19: a meta-analysis of randomised controlled trials. RMD Open. ' '2021;7(3):1–10.', 'journal-title': 'RMD Open.'}, { 'key': '3001_CR31', 'doi-asserted-by': 'crossref', 'unstructured': 'Toro-Huamanchumo CJ, Benites-Meza JK, Mamani-García CS, et al. Efficacy ' 'of colchicine in the treatment of COVID-19 patients: a systematic review ' 'and Meta-analysis. J Clin Med. 2022;11(9)', 'DOI': '10.3390/jcm11092615'}, { 'issue': '6', 'key': '3001_CR32', 'doi-asserted-by': 'publisher', 'first-page': '823', 'DOI': '10.1111/1440-1681.13488', 'volume': '48', 'author': 'TI Hariyanto', 'year': '2021', 'unstructured': 'Hariyanto TI, Halim DA, Jodhinata C, et al. Colchicine treatment can ' 'improve outcomes of coronavirus disease 2019 (COVID-19): a systematic ' 'review and meta-analysis. Clin Exp Pharmacol Physiol. 2021;48(6):823–30.', 'journal-title': 'Clin Exp Pharmacol Physiol.'}, { 'issue': '2', 'key': '3001_CR33', 'doi-asserted-by': 'publisher', 'first-page': '102395', 'DOI': '10.1016/j.dsx.2022.102395', 'volume': '16', 'author': 'AFMZ Zein', 'year': '2022', 'unstructured': 'Zein AFMZ, Raffaello WM. Effect of colchicine on mortality in patients ' 'with COVID-19 – a systematic review and meta-analysis. Diabet Metabol ' 'Syndrome: Clin Res Rev. 2022;16(2):102395.', 'journal-title': 'Diabet Metabol Syndrome: Clin Res Rev.'}, { 'issue': '2', 'key': '3001_CR34', 'doi-asserted-by': 'publisher', 'first-page': '255', 'DOI': '10.1002/iid3.562', 'volume': '10', 'author': 'CS Kow', 'year': '2022', 'unstructured': 'Kow CS, Lee LH, Ramachandram DS, et al. The effect of colchicine on ' 'mortality outcome and duration of hospital stay in patients with ' 'COVID-19: a meta-analysis of randomized trials. Immun Inflamm Disease. ' '2022;10(2):255–64.', 'journal-title': 'Immun Inflamm Disease.'}, { 'issue': '22', 'key': '3001_CR35', 'first-page': '1', 'volume': '19', 'author': 'JW Eikelboom', 'year': '2022', 'unstructured': 'Eikelboom JW, Jolly SS, Belley-Cote EP, et al. Colchicine and the ' 'combination of rivaroxaban and aspirin in patients hospitalised with ' 'COVID-19 (ACT): an open-label, factorial, randomised, controlled trial. ' 'Lancet Respir Med. 2022;19(22):1–9.', 'journal-title': 'Lancet Respir Med.'}], 'container-title': 'BMC Pulmonary Medicine', 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'https://link.springer.com/content/pdf/10.1186/s12890-024-03001-0.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://link.springer.com/article/10.1186/s12890-024-03001-0/fulltext.html', 'content-type': 'text/html', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://link.springer.com/content/pdf/10.1186/s12890-024-03001-0.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2024, 4, 20]], 'date-time': '2024-04-20T02:01:49Z', 'timestamp': 1713578509000}, 'score': 1, 'resource': { 'primary': { 'URL': 'https://bmcpulmmed.biomedcentral.com/articles/10.1186/s12890-024-03001-0'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2024, 4, 20]]}, 'references-count': 35, 'journal-issue': {'issue': '1', 'published-online': {'date-parts': [[2024, 12]]}}, 'alternative-id': ['3001'], 'URL': 'http://dx.doi.org/10.1186/s12890-024-03001-0', 'relation': {}, 'ISSN': ['1471-2466'], 'subject': ['Pulmonary and Respiratory Medicine'], 'container-title-short': 'BMC Pulm Med', 'published': {'date-parts': [[2024, 4, 20]]}, 'assertion': [ { 'value': '4 July 2023', 'order': 1, 'name': 'received', 'label': 'Received', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '8 April 2024', 'order': 2, 'name': 'accepted', 'label': 'Accepted', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '20 April 2024', 'order': 3, 'name': 'first_online', 'label': 'First Online', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, {'order': 1, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Declarations'}}, { 'value': 'Not applicable.', 'order': 2, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Ethics approval and consent to participate'}}, { 'value': 'Not applicable.', 'order': 3, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Consent for publication'}}, { 'value': 'The authors declare no competing interests.', 'order': 4, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Competing interests'}}], 'article-number': '190'}
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Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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