COLCHICINE TREATMENT IN SARS-COV-2 INFECTION: A SYSTEMATIC REVIEW AND META-ANALYSIS

Beran Beran, Azizullah; Mhanna, Mohammed; Waseem, WAHOOD; Ghazaleh, Sami; Sajdeya, Omar; Kalifa, Muhamad; Ayesh, Hazem; Srour, Omar; Mhanna, Asmaa; Altorok, Nezam; Assaly, Ragheb

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