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A Case Control Study to Evaluate the Impact of Colchicine on Patients Admitted to the Hospital with Moderate to Severe COVID-19 Infection

Sandhu et al., Canadian Journal of Infectious Diseases and Medical Microbiology, doi:10.1155/2020/8865954
Oct 2020  
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Mortality 42% Improvement Relative Risk Ventilation 53% Discharge 42% Hospitalization time 5% no CI Colchicine for COVID-19  Sandhu et al.  LATE TREATMENT Is late treatment with colchicine beneficial for COVID-19? Prospective study of 112 patients in the USA Lower mortality (p=0.0006) and ventilation (p<0.0001) c19early.org Sandhu et al., Canadian J. Infectious .., Oct 2020 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.
5,100+ studies for 109 treatments. c19early.org
Prospective cohort study of hospitalized patients in the USA, 34 treated with colchicine, showing lower mortality and intubation with treatment.
risk of death, 41.7% lower, RR 0.58, p < 0.001, treatment 16 of 34 (47.1%), control 63 of 78 (80.8%), NNT 3.0.
risk of mechanical ventilation, 52.9% lower, RR 0.47, p < 0.001, treatment 16 of 34 (47.1%), control 68 of 68 (100.0%), NNT 1.9.
risk of no hospital discharge, 41.7% lower, RR 0.58, p < 0.001, treatment 16 of 34 (47.1%), control 63 of 78 (80.8%), NNT 3.0.
hospitalization time, 4.5% lower, relative time 0.95, treatment 34, control 78.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Sandhu et al., 27 Oct 2020, prospective, USA, peer-reviewed, 4 authors, dosage 1.2mg days 1-3, 0.6mg days 4-15.
This PaperColchicineAll
A Case Control Study to Evaluate the Impact of Colchicine on Patients Admitted to the Hospital with Moderate to Severe COVID-19 Infection
Tegveer Sandhu, Arlene Tieng, Sridhar Chilimuri, Giovanni Franchin
doi:10.1155/2020/8865954
Background. Colchicine has been used in conditions such as periodic febrile illness, acute pericarditis, and gouty arthritis, all having a common hyperinflammatory response as seen in moderate to severe forms of coronavirus disease 2019 . is project was carried out during the rapid surge of cases in New York City, and the goal was to assess the efficacy of colchicine in treating patients with COVID-19. Methods. Patients admitted to two distinct pulmonary oriented floors of the BronxCare Hospital Center were compared. Patients on one floor were given colchicine in addition to standard of care, while control patients from another floor received only standard of care. Patients who had at least two separate timepoint measurements for at least two out of four serum inflammatory markers (C-reactive protein (CRP), D-dimer, ferritin, or lactate dehydrogenase (LDH)) were selected for the final comprehensive analysis. Results. An initial analysis performed on all patients, irrespective of the availability of two timepoint inflammatory markers, revealed a lower mortality (49.1% versus 72.9%, P � 0.002), a lower percentage of intubations (52.8% versus 73.6%, P � 0.006), and a higher discharge rate (50.9% versus 27.1%, P � 0.002), in the patients who received colchicine. Patients in the final comprehensive analysis groups (34 in the colchicine group and 78 in the control group) had a similar prevalence of comorbid medical conditions, except for renal failure, which was higher in the control group (65.3% versus 35.2%, P � 0.015). HTN (71.8% versus 52.9%, P � 0.053) and DM (51.3% versus 32.4%, P � 0.064) were also more prevalent in the control group, although the difference was not statistically significant. Patients who received colchicine had a lower mortality than the control group (47.1% versus 80.8%, P � 0.0003), lower rate of intubations (47.1% versus 87.2%, P < 0.0001), and a higher discharge rate (52.9% versus 19.2%, P � 0.0003). Patients in the colchicine group also showed a more significant decrease in inflammatory markers for D-dimer (P � 0.037), CRP (P � 0.014), and ferritin (P � 0.012). Conclusions. Our study demonstrates that colchicine improved outcomes in patients with COVID-19 receiving standard of care therapy. Future randomized, placebo-controlled clinical trials to assess the potential benefit of colchicine in COVID-19 are warranted.
Conflicts of Interest e authors declare that there are no conflicts of interest regarding the publication of this paper.
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Patients admitted to two ' 'distinct pulmonary oriented floors of the BronxCare Hospital Center were compared. Patients ' 'on one floor were given colchicine in addition to standard of care, while control patients ' 'from another floor received only standard of care. Patients who had at least two separate ' 'timepoint measurements for at least two out of four serum inflammatory markers (C-reactive ' 'protein (CRP), D-dimer, ferritin, or lactate dehydrogenase (LDH)) were selected for the final ' 'comprehensive analysis. Results. An initial analysis performed on all patients, irrespective ' 'of the availability of two timepoint inflammatory markers, revealed a lower mortality (49.1% ' 'versus 72.9%, <jats:inline-formula>\n' ' <math xmlns="http://www.w3.org/1998/Math/MathML" id="M1">\n' ' <mi>P</mi>\n' ' <mo>=</mo>\n' ' <mn>0.002</mn>\n' ' </math>\n' ' </jats:inline-formula>), a lower percentage of intubations (52.8% versus ' '73.6%, <jats:inline-formula>\n' ' <math xmlns="http://www.w3.org/1998/Math/MathML" id="M2">\n' ' <mi>P</mi>\n' ' <mo>=</mo>\n' ' <mn>0.006</mn>\n' ' </math>\n' ' </jats:inline-formula>), and a higher discharge rate (50.9% versus 27.1%, ' '<jats:inline-formula>\n' ' <math xmlns="http://www.w3.org/1998/Math/MathML" id="M3">\n' ' <mi>P</mi>\n' ' <mo>=</mo>\n' ' <mn>0.002</mn>\n' ' </math>\n' ' </jats:inline-formula>), in the patients who received colchicine. Patients ' 'in the final comprehensive analysis groups (34 in the colchicine group and 78 in the control ' 'group) had a similar prevalence of comorbid medical conditions, except for renal failure, ' 'which was higher in the control group (65.3% versus 35.2%, <jats:inline-formula>\n' ' <math xmlns="http://www.w3.org/1998/Math/MathML" id="M4">\n' ' <mi>P</mi>\n' ' <mo>=</mo>\n' ' <mn>0.015</mn>\n' ' </math>\n' ' </jats:inline-formula>). HTN (71.8% versus 52.9%, <jats:inline-formula>\n' ' <math xmlns="http://www.w3.org/1998/Math/MathML" id="M5">\n' ' <mi>P</mi>\n' ' <mo>=</mo>\n' ' <mn>0.053</mn>\n' ' </math>\n' ' </jats:inline-formula>) and DM (51.3% versus 32.4%, <jats:inline-formula>\n' ' <math xmlns="http://www.w3.org/1998/Math/MathML" id="M6">\n' ' <mi>P</mi>\n' ' <mo>=</mo>\n' ' <mn>0.064</mn>\n' ' </math>\n' ' </jats:inline-formula>) were also more prevalent in the control group, ' 'although the difference was not statistically significant. Patients who received colchicine ' 'had a lower mortality than the control group (47.1% versus 80.8%, <jats:inline-formula>\n' ' <math xmlns="http://www.w3.org/1998/Math/MathML" id="M7">\n' ' <mi>P</mi>\n' ' <mo>=</mo>\n' ' <mn>0.0003</mn>\n' ' </math>\n' ' </jats:inline-formula>), lower rate of intubations (47.1% versus 87.2%, ' '<jats:inline-formula>\n' ' <math xmlns="http://www.w3.org/1998/Math/MathML" id="M8">\n' ' <mi>P</mi>\n' ' <mo>&lt;</mo>\n' ' <mn>0.0001</mn>\n' ' </math>\n' ' </jats:inline-formula>), and a higher discharge rate (52.9% versus 19.2%, ' '<jats:inline-formula>\n' ' <math xmlns="http://www.w3.org/1998/Math/MathML" id="M9">\n' ' <mi>P</mi>\n' ' <mo>=</mo>\n' ' <mn>0.0003</mn>\n' ' </math>\n' ' </jats:inline-formula>). Patients in the colchicine group also showed a ' 'more significant decrease in inflammatory markers for D-dimer (<jats:inline-formula>\n' ' <math xmlns="http://www.w3.org/1998/Math/MathML" id="M10">\n' ' <mi>P</mi>\n' ' <mo>=</mo>\n' ' <mn>0.037</mn>\n' ' </math>\n' ' </jats:inline-formula>), CRP (<jats:inline-formula>\n' ' <math xmlns="http://www.w3.org/1998/Math/MathML" id="M11">\n' ' <mi>P</mi>\n' ' <mo>=</mo>\n' ' <mn>0.014</mn>\n' ' </math>\n' ' </jats:inline-formula>), and ferritin (<jats:inline-formula>\n' ' <math xmlns="http://www.w3.org/1998/Math/MathML" id="M12">\n' ' <mi>P</mi>\n' ' <mo>=</mo>\n' ' <mn>0.012</mn>\n' ' </math>\n' ' </jats:inline-formula>). Conclusions. Our study demonstrates that ' 'colchicine improved outcomes in patients with COVID-19 receiving standard of care therapy. ' 'Future randomized, placebo-controlled clinical trials to assess the potential benefit of ' 'colchicine in COVID-19 are warranted.</jats:p>', 'DOI': '10.1155/2020/8865954', 'type': 'journal-article', 'created': { 'date-parts': [[2020, 10, 27]], 'date-time': '2020-10-27T20:20:06Z', 'timestamp': 1603830006000}, 'page': '1-9', 'source': 'Crossref', 'is-referenced-by-count': 43, 'title': 'A Case Control Study to Evaluate the Impact of Colchicine on Patients Admitted to the Hospital ' 'with Moderate to Severe COVID-19 Infection', 'prefix': '10.1155', 'volume': '2020', 'author': [ { 'ORCID': 'http://orcid.org/0000-0002-9253-9868', 'authenticated-orcid': True, 'given': 'Tegveer', 'family': 'Sandhu', 'sequence': 'first', 'affiliation': [ { 'name': 'Department of Internal Medicine, BronxCare Health System, Bronx, ' 'NY 10457, USA'}]}, { 'ORCID': 'http://orcid.org/0000-0002-1292-2198', 'authenticated-orcid': True, 'given': 'Arlene', 'family': 'Tieng', 'sequence': 'additional', 'affiliation': [ 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Late treatment
is less effective
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