Reduced mortality in COVID-19 patients treated with colchicine: Results from a retrospective, observational study
Lucio Manenti, Umberto Maggiore, Enrico Fiaccadori, Tiziana Meschi, Anna Degli Antoni, Antonio Nouvenne, Andrea Ticinesi, Nicoletta Cerundolo, Beatrice Prati, Marco Delsante, Ilaria Gandoflini, Lorenzo Donghi, Micaela Gentile, Maria Teresa Farina, Vincenzo Oliva, Cristina Zambrano, Giuseppe Regolisti, Alessandra Palmisano, Caterina Caminiti, Enrico Cocchi, Carlo Ferrari, Leonardo V Riella, Paolo Cravedi, Licia Peruzzi
PLOS ONE, doi:10.1371/journal.pone.0248276
Objectives Effective treatments for coronavirus disease 2019 (COVID-19) are urgently needed. We hypothesized that colchicine, by counteracting proinflammatory pathways implicated in the uncontrolled inflammatory response of COVID-19 patients, reduces pulmonary complications, and improves survival.
Methods This retrospective study included 71 consecutive COVID-19 patients (hospitalized with pneumonia on CT scan or outpatients) who received colchicine and compared with 70 control patients who did not receive colchicine in two serial time periods at the same institution. We used inverse probability of treatment propensity-score weighting to examine differences in mortality, clinical improvement (using a 7-point ordinary scale), and inflammatory markers between the two groups.
Results Amongst the 141 hospitalized), 70 (50%) received colchicine. The 21-day crude cumulative mortality was 7.5% in the colchicine group and 28.5% in the control group (P = 0.006; adjusted hazard ratio: 0.24 [95%CI: 0.09 to 0.67]); 21-day
Supporting information
S1 Table. Demographic and clinical characteristics of the study population after propen
Author Contributions Conceptualization: Lucio Manenti, Umberto Maggiore, Paolo Cravedi, Licia Peruzzi.
Data curation: Lucio Manenti.
Formal analysis: Lucio Manenti. Writing -original draft: Lucio Manenti, Umberto Maggiore, Paolo Cravedi.
Writing -review & editing: Umberto Maggiore, Enrico Fiaccadori, Tiziana Meschi, Anna Degli Antoni, Antonio Nouvenne, Andrea Ticinesi, Nicoletta Cerundolo, Beatrice Prati, Marco Delsante, Ilaria Gandoflini, Lorenzo Donghi, Micaela Gentile, Maria Teresa Farina, Vincenzo Oliva, Cristina Zambrano, Giuseppe Regolisti, Alessandra Palmisano, Caterina Caminiti, Enrico Cocchi, Carlo Ferrari, Leonardo V. Riella, Paolo Cravedi, Licia Peruzzi.
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'abstract': '<jats:sec id="sec001">\n'
'<jats:title>Objectives</jats:title>\n'
'<jats:p>Effective treatments for coronavirus disease 2019 (COVID-19) are urgently needed. We '
'hypothesized that colchicine, by counteracting proinflammatory pathways implicated in the '
'uncontrolled inflammatory response of COVID-19 patients, reduces pulmonary complications, and '
'improves survival.</jats:p>\n'
'</jats:sec>\n'
'<jats:sec id="sec002">\n'
'<jats:title>Methods</jats:title>\n'
'<jats:p>This retrospective study included 71 consecutive COVID-19 patients (hospitalized with '
'pneumonia on CT scan or outpatients) who received colchicine and compared with 70 control '
'patients who did not receive colchicine in two serial time periods at the same institution. '
'We used inverse probability of treatment propensity-score weighting to examine differences in '
'mortality, clinical improvement (using a 7-point ordinary scale), and inflammatory markers '
'between the two groups.</jats:p>\n'
'</jats:sec>\n'
'<jats:sec id="sec003">\n'
'<jats:title>Results</jats:title>\n'
'<jats:p>Amongst the 141 COVID-19 patients (118 [83.7%] hospitalized), 70 (50%) received '
'colchicine. The 21-day crude cumulative mortality was 7.5% in the colchicine group and 28.5% '
'in the control group (P = 0.006; adjusted hazard ratio: 0.24 [95%CI: 0.09 to 0.67]); 21-day '
'clinical improvement occurred in 40.0% of the patients on colchicine and in 26.6% of control '
'patients (adjusted relative improvement rate: 1.80 [95%CI: 1.00 to 3.22]). The strong '
'association between the use of colchicine and reduced mortality was further supported by the '
'diverging linear trends of percent daily change in lymphocyte count (P = 0.018), '
'neutrophil-to-lymphocyte ratio (P = 0.003), and in C-reactive protein levels (P = 0.009). '
'Colchicine was stopped because of transient side effects (diarrhea or skin rashes) in 7% of '
'patients.</jats:p>\n'
'</jats:sec>\n'
'<jats:sec id="sec004">\n'
'<jats:title>Conclusion</jats:title>\n'
'<jats:p>In this retrospective cohort study colchicine was associated with reduced mortality '
'and accelerated recovery in COVID-19 patients. This support the rationale for current larger '
'randomized controlled trials testing the safety/efficacy profile of colchicine in COVID-19 '
'patients.</jats:p>\n'
'</jats:sec>',
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