Beneficial effects of colchicine for moderate to severe COVID-19: a randomized, double-blinded, placebo controlled clinical trial
Systemic inflammation is an important characteristic of moderate to severe cases of COVID-19. Colchicine has been successfully used for decades for the treatment of systemic autoinflammatory diseases. There are ongoing researches to study its use for the treatment of the systemic inflammation caused by SARS-CoV-2 infection. Maria Isabel Lopes and colleagues published research in Rheumatoid and Musculoskeletal Disease Journal under the title “Beneficial effects of colchicine for moderate to severe COVID-19: a randomized, double-blinded, placebo-controlled clinical trial”. The summary of this article is given below:
Objective:
To investigate the outcome of adding colchicine to standard treatment for COVID-19.
Method:
This is a randomized, double-blinded, placebo-controlled clinical trial conducted between 11 April to 30 August 2020. 75 patients with moderate to severe COVID-19 were allocated in a 1:1 ratio. They were initiated with a colchicine regimen of 0.5mg thrice daily for 5days, then 0.5mg twice daily for 5days. The main outcome included time of hospitalization, need for admission and length of stay in ICU, supplemental oxygen need, and death rate.
Findings:
Colchicine is found to abandoned oxygen supplementation earlier, reduced the length of hospitalization, diminished costs, and the need for hospital beds. Additionally, the treatment with colchicine is not expensive. Investigators supposed that the effect of colchicine in reducing systemic inflammation might not be enough for every patient and that for some of the patients no intervention would prevent respiratory failure. The association of obesity and inflammation has potential physiological effects, the action of colchicine might be limited in such conditions. The study highlights that this drug doesn’t contribute to hepatic or cardiac adverse events nor it causes immunosuppression.
Clinical improvement was evident in the serum CRP report. Colchicine was found to be safe and well-tolerated.
Limitation:
The study had a small sample size. Additionally, investigators were not able to evaluate the capacity of colchicine to avoid admission to ICU and reduce mortality. The absence of mechanistic investigations is another limitation.
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