Colchicine anti-inflammatory therapy for non-intensive care unit hospitalized COVID-19 patients: results from a pilot open-label, randomized controlled clinical trial.

Systemic inflammation is a hallmark of severe coronavirus disease-19 (COVID-19). Anti-inflammatory therapy is considered crucial to modulate the hyperinflammatory response (cytokine storm) in hospitalized COVID-19 patients. There is currently no specific, conclusively proven, cost-efficient, and worldwide available anti-inflammatory therapy available to treat COVID-19 patients with cytokine storm. The present study aimed to investigate the treatment benefit of oral colchicine for hospitalized COVID-19 patients with suspected cytokine storm. Colchicine is an approved drug and possesses multiple anti-inflammatory mechanisms. This was a pilot, open-label randomized controlled clinical trial comparing standard of care (SOC) plus oral colchicine (colchicine arm) vs. SOC alone (control arm) in non-ICU hospitalized COVID-19 patients with suspected cytokine storm. Colchicine treatment was initiated within first 48 hours of admission delivered at 1.5 mg loading dose, followed by 0.5 mg b.i.d. for next 6 days and 0.5 mg q.d. for the second week. A total of 96 patients were randomly allocated to the colchicine (n=48) and control groups (n=48). Both colchicine and control group patients experienced similar clinical outcomes by day 14 of hospitalization. Treatment outcome by day 14 in colchicine vs control arm: recovered and discharged alive: 36 (75.0%) vs. 37 (77.1%), remain admitted after 14-days: 4 (8.3%) vs. 5 (10.4%), ICU transferred: 4 (8.3%) vs. 3 (6.3%), and mortality: 4 (8.3%) vs. 3 (6.3%). The speed of improvement of COVID-19 acute symptoms including shortness of breath, fever, cough, the need of supplementary oxygen, and oxygen saturation level, was almost identical in the two groups. Length of hospitalization was on average 1.5 day shorter in the colchicine group. There was no evidence for a difference between the two groups in the follow-up serum levels of inflammatory biomarkers including C-reactive protein (CRP), D-dimer, lactate dehydrogenase (LDH), ferritin, interleukin-6 (IL-6), high-sensitivity troponin T (hs-TnT) and N-terminal pro b-type natriuretic peptide (NT pro-BNP). According to the results of our study, oral colchicine does not appear to show clinical benefits in non-ICU hospitalized COVID-19 patients with suspected cytokine storm. It is possible that the anti-inflammatory pathways of colchicine are not crucially involved in the pathogenesis of COVID-19.

Functional food plants and their potential antiviral and immunomodulatory properties: The covid-19 perspective

The pandemic of coronavirus disease (Covid-19) which is caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), is continuously hitting the world and millions of individuals have been affected so far. Limited therapeutic options are available for the treatment of Covid-19 while scientists around the globe are working hard to make the vaccines clinically available to the maximum human population. Alarmingly, SARS-CoV-2 variants of SRAS-CoV-2 are emerging in different regions of the world, hence threatening the efficacy of the clinically available vaccines. In such a scenario, the utilization of medicinal plants or traditional medicine could be the most preferred choice along with the precautionary measure to be adopted against the Covid-19. The current article has summarized few important food plants that have previously exhibited promising immunomodulatory or antiviral activities. These medicinal plants could be suggested for boosting the immune system and could be utilized against their utilization against SARS-CoV-2. It could be concluded that medicinal plants especially Allium sativum, Curcuma longa, and Allium cepa along with other plants/herbs/spices could not only be used against SARS-CoV-2 but also other viral, bacterial, or other parasitic diseases other prevalent diseases prevalent in the region. © Pakistan Academy of Sciences.