Abstract
Colchicine is an ancient agent with well-known anti-inflammatory effects and commonly used in treatment of hyperinflammatory conditions. It has been argued that colchicine could be an appropriate treatment option in COVID-19 to control hyperinflammatory response. Here in this study, we aimed to investigate the impact of colchicine on outcomes of COVID-19 in our inpatient cohort. In this retrospective cohort study, hospitalized COVID-19 patients were investigated. Demographics, comorbidities, COVID-19 symptoms, laboratory findings on admission and discharge, baseline and seventh day oxygenation status, rates of mortality, intensive care unit admission, administration of other anti-inflammatory treatments and length of hospital stay were compared between patients who received standard of care medications and who received colchicine additionally. Three hundred and thirty-six patients were included in the study (171 standard of care, 165 standard of care plus colchicine). The median length of hospital stay in colchicine group was significantly shorter. Rates of admission to intensive care unit, anti-inflammatory treatment administration and mortality did not differentiate between standard of care and colchicine groups. However, reduced rates of mortality and ICU admission were observed in patients who received colchicine with a dose of 1 mg/day when compared to patients who received 0.5 mg/day. Our study demonstrated that COVID-19 patients who received colchicine in addition to standard of care had shorter hospital stay. Our results further support the use of colchicine in treatment of COVID-19, particularly with a dose of 1 mg/day.
Highlights
Colchicine is an ancient agent with well-known anti-inflammatory effects and commonly used in treatment of hyperinflammatory conditions
Colchicine, an alkaloid derived from Colchicum autumnale, inhibits intracellular microtubules leading to alterations in various inflammatory processes including superoxide production, neutrophil chemotaxis and adhesion by affecting the cytokine network through interleukin (IL) 1β inhibition [4,5]
Reduced rates of mortality and intensive care unit (ICU) admission were observed in patients who received colchicine with a dose of 1 mg/day when compared to patients who received 0.5 mg/day (Table 6)
Summary
Colchicine is an ancient agent with well-known anti-inflammatory effects and commonly used in treatment of hyperinflammatory conditions. Demographics, comorbidities, COVID19 symptoms, laboratory findings on admission and discharge, baseline and seventh day oxygenation status, rates of mortality, intensive care unit admission, administration of other anti-inflammatory treatments and length of hospital stay were compared between patients who received standard of care medications and who received colchicine . Rates of admission to intensive care unit, anti-inflammatory treatment administration and mortality did not differentiate between standard of care and colchicine groups. Conclusions: Our study demonstrated that COVID-19 patients who received colchicine in addition to standard of care had shorter hospital stay. Hyperinflammation in COVID-19 manifests as an exaggerated and dysfunctional innate immune reaction resembling other autoinflammatory conditions such as macrophage activation syndrom [2] Clinical manifestations of this hyperimmune response comprise fever exceeding 38.4 °C, leukocytosis, macrocytosis, lymphopenia, anemia or thrombocytopenia. As a potent anti-inflammatory agent, colchicine has been used in many inflammasome-mediated autoinflammatory conditions such as familial Mediterranean fever (FMF), Behçet’s disease, crystal induced arthritis and recurrent pericarditis [6]
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