Meta-analysis of the Effect of Colchicine on Mortality and Mechanical Ventilation in COVID-19
Salah et al.,
Meta-analysis of the Effect of Colchicine on Mortality and Mechanical Ventilation in COVID-19,
The American Journal of Cardiology, doi:10.1016/j.amjcard.2021.02.005
Meta analysis of 8 studies, showing significantly lower COVID-19 mortality with colchicine.
Currently there are
48 colchicine studies and meta analysis shows:
risk of death, 38.0% lower, RR 0.62, p < 0.001.
|
risk of mechanical ventilation, 25.0% lower, RR 0.75, p = 0.27.
|
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
|
Salah et al., 30 Apr 2021, peer-reviewed, 2 authors.
Abstract: 170
The American Journal of Cardiology (www.ajconline.org)
time frame analysis showed a significant
drop in hospitalization rates just after PC
encounters, and continued to decrease
over time (Panel A). The annual trends
for 90-day all-cause hospitalization
rates before PC encounters showed a
significant reduction over time
(59.7% in 2010 to 53.3% in 2018, p
<0.001), but hospitalization rates
after PC remained stable over the
study period (Panel B).
In this observational nationwide
analysis of over 25,000 acute on
chronic HF admissions, PC encounters
were associated with a significant
reduction in all-cause, HF-specific, and
non-HF 90-day hospitalization rates.
This reduction was noted immediately
after discharge from the index admission with a PC encounter. Hospitalization rates before PC utilization
decreased over the study period perhaps
due to the early recognition of value of
PC among these sick patients.
This study is limited by the nature of
this administrative database which carries a risk of mis- or under-coding.
Additionally, we could not identify
patients who died after hospital discharge. Some of the reduction in readmission may be due to this factor.
However, it is unlikely that death would
account for the entire decrease
in admission rates after a hospital PC
consultation, since not all patients seen
by PC physicians are appropriate for
hospice or accept a palliative approach
to care, and the previously reported
post-HF discharge 30-day mortality
rate »7% (1). Moreover, the philosophical change of care to a palliative
approach encourages a decrease in
low-value health care utilization such
as repeat hospital admissions at the
end of life. In summary, we found that
patients who received a PC encounter
during a hospitalization had a reduction in subsequent readmission rates.
Further studies should assess the competing risk of death in this population.
Disclosure: The authors have nothing
to disclose, and no relationship with
industry.
Funding: Self-funded
Ahmed Elkaryoni, MDa,*
Brett W. Sperry, MDb
Anna Royce, MDc
Kevin Walsh, MDd
Elizabeth Bruno, MDd
Subir Shah, DOa,d
Amir Darki, MD MSca,d
Islam Y. Elgendy, MDe
a
Division of Cardiovascular Disease, Loyola
University Medical Center, Loyola Stritch School of
Medicine, Maywood, Illinois
b
Division of Cardiovascular Disease, Mid America
Heart Institute, University of Missouri-Kansas City,
Kansas City, Missouri
c
Department of Internal Medicine, University of
Oklahoma, Oklahoma
d
Department of Internal Medicine, Loyola
University Medical Center, Loyola Stritch School of
Medicine, Maywood, Illinois
e
Divison of Cardiology, Weill Cornell MedicineQatar, Doha, Qatar
27 January 2021
1. Virani SS, Alonso A, Benjamin EJ, Bittencourt
MS, Callaway CW, Carson AP, Chamberlain
AM, Chang AR, Cheng S, Delling FN, Djousse
L, Elkind MSV, Ferguson JF, Fornage M, Khan
SS, Kissela BM, Knutson KL, Kwan TW, Lackland DT, Lewis TT, Lichtman JH, Longenecker
CT, Loop MS, Lutsey PL, Martin SS, Matsushita K, Moran AE, Mussolino ME, Perak AM,
Rosamond WD, Roth GA, Sampson UKA,
Satou GM, Schroeder EB, Shah SH, Shay CM,
Spartano NL, Stokes A, Tirschwell DL, VanWagner LB, Tsao CW, American Heart Association Council on Epidemiology and Prevention
Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics2020 update: a report from the American Heart
Association. Circulation 2020;141:e139–e596.
2. Diop MS, Bowen GS, Jiang L, Wu WC, Cornell
PY, Gozalo P, Rudolph JL...
Please send us corrections, updates, or comments. Vaccines and
treatments are complementary. All practical, effective, and safe means should
be used based on risk/benefit analysis. No treatment, vaccine, 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.
Submit