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COLCHICINE TREATMENT IN SARS-COV-2 INFECTION: A SYSTEMATIC REVIEW AND META-ANALYSIS
Chest ; 160(4):A521, 2021.
Article in English | EMBASE | ID: covidwho-1457613
ABSTRACT
TOPIC Chest Infections TYPE Original Investigations

PURPOSE:

Exaggerated inflammatory response with cytokine storm is the hallmark of moderate to severe cases of COVID-19. Several studies have investigated the use of colchicine in COVID-19 due to its anti-inflammatory effects. However, the data regarding its efficacy is still limited and conflicting. This meta-analysis aimed to evaluate the impact of colchicine on mortality and the risk of mechanical ventilation in patients with COVID-19.

METHODS:

We performed a comprehensive literature search of electronic databases from inception through April 10, 2021, for all peer-reviewed studies that evaluated the clinical benefits of colchicine COVID-19 patients. The primary outcome was the mortality rate. The secondary outcomes included the risk of mechanical ventilation, improvement in systematic inflammation as indicated by changes in serum C-reactive protein, and the risk of adverse events. Pooled risk ratio (RR) and 95% confidence intervals (CIs) were obtained by the Mantel-Haenszel method within a random-effect model.

RESULTS:

A total of eight studies involving 926 COVID-19 patients (406 patients received colchicine along with standard-of-care (SOC) therapy and 520 received SOC therapy alone) were included. The mean age was 63.7±14.7 years, and males represented 63.3%. Mortality rate was significantly lower in the colchicine group compared to SOC (RR 0.49 (95% CI 0.34-0.72, P = 0.0002). However, there was no statistically significant difference in the risk of mechanical ventilation (RR 0.69, 95% CI 0.31-1.57, P = 0.38). Furthermore, colchicine significantly lowered serum CRP levels (MD -0.40, 95% CI -0.77 to -0.03, P = 0.03).

CONCLUSIONS:

Our meta-analysis demonstrated that colchicine showed improvement in mortality in COVID-19 patients. However, there was no significant improvement in the risk of mechanical ventilation. CLINICAL IMPLICATIONS Colchicine may be a potential therapeutic option for COVID-19. Even though the results are encouraging, we need more large-scale RCTs to better characterize the clinical benefits of colchicine in COVID-19 patients. DISCLOSURES No relevant relationships by Nezam Altorok, source=Web Response No relevant relationships by Ragheb Assaly, source=Web Response No relevant relationships by Hazem Ayesh, source=Web Response No relevant relationships by Azizullah Beran Beran, source=Web Response No relevant relationships by Sami Ghazaleh, source=Web Response No relevant relationships by Muhamad Kalifa, source=Web Response No relevant relationships by Mohammed Mhanna, source=Web Response No relevant relationships by Asmaa Mhanna, source=Web Response No relevant relationships by Omar Sajdeya, source=Web Response No relevant relationships by Omar Srour, source=Web Response No relevant relationships by WAHOOD Waseem, source=Web Response

Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Reviews / Systematic review/Meta Analysis Language: English Journal: Chest Year: 2021 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Reviews / Systematic review/Meta Analysis Language: English Journal: Chest Year: 2021 Document Type: Article