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

{ 'indexed': {'date-parts': [[2024, 4, 21]], 'date-time': '2024-04-21T00:33:11Z', 'timestamp': 1713659591943}, 'reference-count': 35, 'publisher': 'Springer Science and Business Media LLC', 'issue': '1', 'license': [ { 'start': { 'date-parts': [[2024, 4, 20]], 'date-time': '2024-04-20T00:00:00Z', 'timestamp': 1713571200000}, 'content-version': 'tdm', 'delay-in-days': 0, 'URL': 'https://creativecommons.org/licenses/by/4.0'}, { 'start': { 'date-parts': [[2024, 4, 20]], 'date-time': '2024-04-20T00:00:00Z', 'timestamp': 1713571200000}, 'content-version': 'vor', 'delay-in-days': 0, 'URL': 'https://creativecommons.org/licenses/by/4.0'}], 'funder': [{'DOI': '10.13039/501100002352', 'name': 'Ain Shams University', 'doi-asserted-by': 'crossref'}], 'content-domain': {'domain': ['link.springer.com'], 'crossmark-restriction': False}, 'abstract': '<jats:title>Abstract</jats:title><jats:sec>\n' ' <jats:title>Background</jats:title>\n' ' <jats:p>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.</jats:p>\n' ' </jats:sec><jats:sec>\n' ' <jats:title>Objective</jats:title>\n' ' <jats:p>The aim of the current study was to assess the evidence of colchicine ' 'effectiveness in COVID-19 treatment.</jats:p>\n' ' </jats:sec><jats:sec>\n' ' <jats:title>Methods</jats:title>\n' ' <jats:p>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.</jats:p>\n' ' </jats:sec><jats:sec>\n' ' <jats:title>Results</jats:title>\n' ' <jats:p>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, <jats:italic>P</jats:italic>\u2009=\u20090.000024). 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, <jats:italic>P</jats:italic>\u2009=\u20090.042). However, colchicine had no ' 'effect on mortality and the need for mechanical ventilation among this subgroup.</jats:p>\n' ' </jats:sec><jats:sec>\n' ' <jats:title>Conclusion</jats:title>\n' ' <jats:p>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.</jats:p>\n' ' </jats:sec>', 'DOI': '10.1186/s12890-024-03001-0', 'type': 'journal-article', 'created': {'date-parts': [[2024, 4, 20]], 'date-time': '2024-04-20T02:01:39Z', 'timestamp': 1713578499000}, 'update-policy': 'http://dx.doi.org/10.1007/springer_crossmark_policy', 'source': 'Crossref', 'is-referenced-by-count': 0, 'title': 'The role of colchicine in the management of COVID-19: a Meta-analysis', 'prefix': '10.1186', 'volume': '24', 'author': [ {'given': 'Kholoud', 'family': 'Elshiwy', 'sequence': 'first', 'affiliation': []}, {'given': 'Ghada Essam El-Din', 'family': 'Amin', 'sequence': 'additional', 'affiliation': []}, {'given': 'Mohamed Nazmy', 'family': 'Farres', 'sequence': 'additional', 'affiliation': []}, {'given': 'Rasha', 'family': 'Samir', 'sequence': 'additional', 'affiliation': []}, {'given': 'Mohamed Farouk', 'family': 'Allam', 'sequence': 'additional', 'affiliation': []}], 'member': '297', 'published-online': {'date-parts': [[2024, 4, 20]]}, 'reference': [ { 'key': '3001_CR1', 'doi-asserted-by': 'publisher', 'first-page': '117863612311903', 'DOI': '10.1177/11786361231190334', 'volume': '16', 'author': 'MT Rahman', 'year': '2023', 'unstructured': 'Rahman MT, et al. 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