Colchicine Shows Promise Against Moderate and Severe COVID-19

The time to recovery from COVID-19 infection was significantly decreased among patients with moderate and severe disease who received adjuvant colchicine with standard therapy, according to findings published in Annals of Medicine and Surgery.

Owing to its potent anti-inflammatory effects and potential antiviral properties via microtubule polymerization inhibition, researchers sought to evaluate the use of colchicine for COVID-19 infection.

This randomized controlled open-label trial was conducted between April 2021 and August 2021 and included adult patients diagnosed with moderate and severe COVID-19 infection. Patients (N=160) were divided into 2 arms on the basis of disease severity and then randomly assigned into 4 groups (each n=40) in a 1:1:1:1 fashion to receive either adjuvant colchicine with standard therapy or standard therapy alone (controls). Researchers compared the rate of survival, time to recovery, and adverse events between the groups.

Among all patients included in the analysis, the mean age was 49 (range, 37-60.5) years, 85 (53.1%) were men, and no statistically significant group differences were observed for age, sex, smoking status, comorbidities, or risk of death.

Compared with patients in the control groups, the time between symptom onset and recovery decreased by a mean of 2 and 5 days among patients who received colchicine in the moderate and severe disease groups, respectively. The time between treatment initiation and recovery also decreased among patients in the colchicine groups, with mean decreases of 3 and 4 days among those with moderate and severe disease, respectively.

Adverse events potentially related to colchicine were reported by 8 (20%) patients with severe disease and 3 (7.5%) with moderate disease. Of the 11 total events, 8 were gastrointestinal-related events and none required subsequent treatment discontinuation.

The researchers found that severe disease (adjusted hazard ratio [aHR], 0.72; P =.07), delayed treatment initiation (aHR, 0.74; P <.001), and older age (aHR, 0.59; P =.015) were associated with a decreased likelihood of recovery.

Limitations included the open-label design, small sample size, and single-center setting.

These findings “endorse the theory that colchicine… mainly [has] anti-inflammatory and immunomodulatory [activity] rather than antiviral activity,” the researchers concluded.

Reference

Gorial FI, Maulood MF, Abdulamir AS, Alnuaimi AS, Abdulrrazaq MK, Bonyan FA. Randomized controlled trial of colchicine add on to the standard therapy in moderate and severe corona virus disease-19 infection. Ann Med Surg. Published online April 2, 2022. doi.10.1016/j.amsu.2022.103593