Repurposing Colchicine in Treating Patients with COVID-19: A Systematic Review and Meta-Analysis
Chi-Hone Lien, Ming-Dar Lee, Shun-Long Weng, Chao-Hsu Lin, Lawrence Yu-Min Liu, Yu-Lin Tai, Wei-Te Lei, Jui-Ming Liu, Ya-Ning Huang, Hsin Chi, Nan-Chang Chiu, Chien-Yu Lin
Life, doi:10.3390/life11080864
Coronavirus disease 2019 (COVID-19) had caused huge health losses worldwide. Several drugs had been applied to treat patients with COVID-19, and repurposing colchicine had been proposed for its anti-inflammatory properties via several pathways. In this systematic review, we evaluated the effects of colchicine treatment. From inception to May 31, 2021, databases, including PubMed, EMbase, medRxiv, and Research Square were searched, and 11 studies were enrolled. A total of 17,205 COVID-19 patients with male predominance (62.9%) were analyzed. Patients with colchicine treatment had a significantly lower risk of mortality (odds ratio (OR): 0.57, 95% confidence interval (CI): 0.38-0.87, I 2 : 72%; p < 0.01) and a non-significantly lower rate of mechanical ventilation (OR: 0.67, 95%CI: 0.39-1.15). The side effects were mild and not significantly different (OR: 2.03, 95%CI: 0.51-8.09). Subgroup analysis with randomized controlled trials showed no statistically significant difference in the mortality (OR: 0.80, 95%CI: 0.44-1.46, I 2 : 33%; p = 0.22). In conclusion, our meta-analysis found that colchicine treatment was associated with a significantly lower risk of mortality in patients with COVID-19. However, this benefit was not observed in the subgroup analysis of randomized controlled trials. Further randomized controlled studies are required to confirm the potential benefits of colchicine treatment.
Conclusions In conclusion, our systematic review and meta-analysis identified 17,205 COVID-19 patients, and we found that a significant reduction in mortality in patients with colchicine treatment (OR: 0.57). The results were similar with subgroup analysis for different mortality rates. However, moderate heterogeneity was observed, and the dose, interval, duration, and mortality rate varied across studies. Further subgroup analysis with randomized controlled trials showed a non-significant decrease. Funnel plots and Egger's test demonstrated a significant publication bias in both meta-analysis of all studies and randomized controlled trials. Therefore, further well-designed randomized controlled trials were required to elucidate the benefits of colchicine treatment and determine the optimal regimen. Although colchicine was cheap, easily available, accessible, and safe, routine colchicine treatment was not recommended based on our systematic review and meta-analysis.
Supplementary Materials: The following are available online at https://www.mdpi.com/article/10 .3390/life11080864/s1, Supplementary File S1, Complete search strategy of our systematic review. Supplementary File S2, Funnel plot of enrolled studies investigating the subsequent mortality of colchicine and control groups. Supplementary File S3, Contour-enhanced funnel plot of enrolled studies investigating subsequent mortality of colchicine and control groups. Supplementary File S4, Egger's test of enrolled studies..
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