Efficacy of Colchicine and Budesonide in Improvement Outcomes of Patients with Coronavirus Infection 2019 in Damascus, Syria: A Randomized Control Trial

Mohammad Alsultan,Jafar Barhoum,Muhannad Hag Mosa,Aliaa Bakr,Mohamed Taher Anan,Zain Saleh,Fatima Hujij,Mamdoh Kurdy,Ameer Obeid,Omar Alsamarrai,Nawwar Soliman,Massimiliano Lanzafame

doi:10.1155/2021/2129006

Abstract

COVID-19 was reported in China in 2019 and has spread worldwide. Transmission occurs through respiratory secretions and, less commonly, through contaminated surfaces. The severity of the disease can range from asymptomatic to acute respiratory distress syndrome (ARDS). In this study, we aim to investigate the efficacy of two agents (oral colchicine and budesonide inhaler) in COVID-19 infection management, compared with supportive care alone. 77 patients were admitted to the isolation section of Al Assad University Hospital, between the 1st of August and the 30th of August. A total of 49 patients were included in this randomized control trial, after excluding ineligible patients. The random sample was divided into three groups; the first group was supportive care plus colchicine, the second group was supportive care plus budesonide inhaler, and the control group was supportive care alone. PaO2/FiO2 was improved in the budesonide group, higher than the supportive and colchicine groups. The median hospitalization days were shorter when using colchicine or budesonide, opposed to supportive care alone (8 vs 10 days, respectively). 34 patients (69.3%) were discharged, and 27 patients (55.1%) were followed up until they were weaned from oxygen and made a complete recovery. There was a significant decrease in mortality with colchicine (3 patients; 21.4%) compared with supportive care (7 patients; 33.3%) and the budesonide group (5 patients; 35.7%).

Highlights

COVID-19 was reported in China in 2019 and has spread worldwide
Transmission occurs through respiratory secretions and, less commonly, through contaminated surfaces [1]. e severity of disease can range from asymptomatic to acute respiratory distress syndrome (ARDS). 81% of cases were defined mild if no pneumonia or mild pneumonia was presented; 14% were defined severe when SpO2 ≤93%, respiratory rate ≥30 breaths/min, PaO2/ FiO2 50% within 24 to 48 hours; and 5% were defined critical if septic shock, respiratory failure, and/or multiple organ dysfunction occur [2]
We aim to investigate the efficacy of two agents in COVID19 infection management compared with supportive care alone

Summary

Introduction

COVID-19 was reported in China in 2019 and has spread worldwide. Transmission occurs through respiratory secretions and, less commonly, through contaminated surfaces [1]. e severity of disease can range from asymptomatic to acute respiratory distress syndrome (ARDS). 81% of cases were defined mild if no pneumonia or mild pneumonia was presented; 14% were defined severe when SpO2 ≤93%, respiratory rate ≥30 breaths/min, PaO2/ FiO2 50% within 24 to 48 hours; and 5% were defined critical if septic shock, respiratory failure, and/or multiple organ dysfunction occur [2]. E severity of disease can range from asymptomatic to acute respiratory distress syndrome (ARDS). 81% of cases were defined mild if no pneumonia or mild pneumonia was presented; 14% were defined severe when SpO2 ≤93%, respiratory rate ≥30 breaths/min, PaO2/ FiO2 50% within 24 to 48 hours; and 5% were defined critical if septic shock, respiratory failure, and/or multiple organ dysfunction occur [2]. Other study reported a 49% fatality rate in critical cases [4]. ARDS was divided into three phases: exudative, proliferative, and fibrotic [5]. Several potential mechanisms were implicated; neutrophil accumulation was consistently seen in the early phase of ARDS, which releases several proteolytic enzymes, cytokines (TNF-α, IL-1β, IL-6) [7], and reactive oxygen species [8]

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