The Potential Role of Colchicine in Reducing Mortality and Mechanical Ventilation Rates in COVID-19 Infection: A Meta-analysis
Shilpa Rai, Shahbaz Singh Nijjar, Blessing T. Ojinna, Iqra Mukhtar, Maryam Ahmed, Opeyemi Tobalesi, Prerna Singh, Olamide Adefashola, Abiodun O. Aboaba, Danish Waqar, Jeffrey Ndove, Frederick Ferguson, Adewale Mark Adedoyin, Patrick Batti, Hammad Zafar
Journal of Advances in Medicine and Medical Research, doi:10.9734/jammr/2022/v34i2031503
Background: Colchicine is one of many drugs being repurposed for COVID-19 due to its potential as an anti-inflammatory agent alongside its easy accessibility and oral administration. This study aims to identify the risk reduction in mortality and mechanical ventilation of colchicine-treated COVID-19 patients compared to the standard of care/placebo. Methods: A systematic search was conducted until December 31, 2021, with keywords including Colchicine, COVID-19, SARS-CoV-2, anti-inflammatory, trials, clinical, mechanical ventilation, death, and mortality. Databases including MEDLINE/PubMed, Scopus, Web of Science, CINAHL Plus, Cochrane, WHO Global Database, and Preprint servers were searched. Using dichotomous data for all values, the risk ratios (RR) were calculated by applying the random-effects model in Review Manager 5.4.
Results: The 12 studies pooled 17,297 participants, with 8,528 patients in the colchicine group and 8,769 in the standard care group. Colchicine treatment led to a statistically significant reduction in the risk of death (RR=0.63, 95% CI=0.48-0.84, P=0.001). Moderately high heterogeneity was present among the included studies (I 2 =72%). While insignificant, the risk of mechanical ventilation was decreased by 12% among the colchicine group (RR=0.88, 95% CI=0.64-1.22, P=0.44). Conclusions: While this meta-analysis finds overall reductions in mortality with colchicine treatment, these findings must be utilized with caution. Placebo-controlled randomized clinical trials are warranted at a large scale to validate the viability of colchicine as an adjuvant treatment for COVID-19. On obtaining more concrete findings, the potential role of colchicine may be better optimized in non-severe patients as well, across in-hospital and outpatient settings.
References
Brunetti, Diawara, Tsai, Colchicine to Weather the Cytokine Storm in Hospitalized Patients with COVID-19, J Clin Med,
doi:10.3390/jcm9092961García-Posada, Vesga, Mestra, Clinical outcomes of patients hospitalized for COVID-19 and evidence-based on the pharmacological management reduce mortality in a region of the Colombian Caribbean, J Infect Public Health,
doi:10.1016/j.jiph.2021.02.013Mahale, Rajhans, Godavarthy, A Retrospective Observational Study of Hypoxic COVID-19 Patients Treated with Immunomodulatory Drugs in a Tertiary Care Hospital, Indian J Crit Care Med,
doi:10.5005/jp-journals-10071-23599Manenti, Maggiore, Fiaccadori, Reduced mortality in COVID-19 patients treated with colchicine: Results from a retrospective, observational study, PLoS One,
doi:10.1371/journal.pone.0248276Mori, Taki, Wakabayashi, Colchicine treatment early after infarction attenuates myocardial inflammatory response demonstrated by 14 C-methionine imaging and subsequent ventricular remodeling by quantitative gated SPECT, Ann Nucl Med,
doi:10.1007/s12149-020-01559-3Sandhu, Tieng, Chilimuri, Franchin, A Case Control Study to Evaluate the Impact of Colchicine on Patients Admitted to the Hospital with Moderate to Severe COVID-19 Infection, Can J Infect Dis Med Microbiol,
doi:10.1155/2020/8865954Stewart, Yang, Atkins, Adverse events during oral colchicine
Vrachatis, Giannopoulos, Giotaki, Impact of colchicine on mortality in patients with COVID-19: A meta
Xia, Yang, Qian, Meta-analysis Evaluating the Utility of Colchicine in Secondary Prevention of Coronary Artery Disease, Am J Cardiol,
doi:10.1016/j.amjcard.2020.10.043{ 'indexed': {'date-parts': [[2022, 7, 30]], 'date-time': '2022-07-30T05:13:00Z', 'timestamp': 1659157980483},
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'abstract': '<jats:p>Background: Colchicine is one of many drugs being repurposed for COVID-19 due to its '
'potential as an anti-inflammatory agent alongside its easy accessibility and oral '
'administration. This study aims to identify the risk reduction in mortality and mechanical '
'ventilation of colchicine-treated COVID-19 patients compared to the standard of '
'care/placebo.
\n'
'Methods: A systematic search was conducted until December 31, 2021, with keywords including '
'Colchicine, COVID-19, SARS-CoV-2, anti-inflammatory, trials, clinical, mechanical '
'ventilation, death, and mortality. Databases including MEDLINE/PubMed, Scopus, Web of '
'Science, CINAHL Plus, Cochrane, WHO Global Database, and Preprint servers were searched. '
'Using dichotomous data for all values, the risk ratios (RR) were calculated by applying the '
'random-effects model in Review Manager 5.4.
\n'
'Results: The 12 studies pooled 17,297 participants, with 8,528 patients in the colchicine '
'group and 8,769 in the standard care group. Colchicine treatment led to a statistically '
'significant reduction in the risk of death (RR=0.63, 95% CI=0.48-0.84, P=0.001). Moderately '
'high heterogeneity was present among the included studies (I2=72%). While insignificant, the '
'risk of mechanical ventilation was decreased by 12% among the colchicine group (RR=0.88, 95% '
'CI=0.64-1.22, P=0.44).
\n'
'Conclusions: While this meta-analysis finds overall reductions in mortality with colchicine '
'treatment, these findings must be utilized with caution. Placebo-controlled randomized '
'clinical trials are warranted at a large scale to validate the viability of colchicine as an '
'adjuvant treatment for COVID-19. On obtaining more concrete findings, the potential role of '
'colchicine may be better optimized in non-severe patients as well, across in-hospital and '
'outpatient settings.</jats:p>',
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