The Potential Role of Colchicine in Reducing Mortality and Mechanical Ventilation Rates in COVID-19 Infection: A Meta-analysis
Shilpa Rai
Isra University, Pakistan.
Shahbaz Singh Nijjar
Southern Medical University, China.
Blessing T. OJinna
University of Nigeria College of Medicine, Nigeria.
Iqra Mukhtar *
Al-Nafees Medical College and Hospital, Pakistan.
Maryam Ahmed
Punjab Medical College (PMC), Pakistan.
Opeyemi Tobalesi
University of Ilorin College of Health Sciences, Nigeria.
Prerna Singh
J. J. M Medical College, India.
Olamide Adefashola
Lagos State University College of Medicine, Nigeria.
Abiodun O. Aboaba
Avalon University School of Medicine, Curacao.
Danish Waqar
Wuhan University School of Medicine, China.
Jeffrey Ndove
Carribean Medical University, Curacao.
Frederick Ferguson
Carribean Medical University, Curacao.
Adewale Mark Adedoyin
Lagos State University College of Medicine, Nigeria.
Patrick Batti
American University of Antigua(AUA), Antigua.
Hammad Zafar
Shifa College of Medicine, Pakistan.
*Author to whom correspondence should be addressed.
Abstract
Background: Colchicine is one of many drugs being repurposed for COVID-19 due to its potential as an anti-inflammatory agent alongside its easy accessibility and oral administration. This study aims to identify the risk reduction in mortality and mechanical ventilation of colchicine-treated COVID-19 patients compared to the standard of care/placebo.
Methods: A systematic search was conducted until December 31, 2021, with keywords including Colchicine, COVID-19, SARS-CoV-2, anti-inflammatory, trials, clinical, mechanical ventilation, death, and mortality. Databases including MEDLINE/PubMed, Scopus, Web of Science, CINAHL Plus, Cochrane, WHO Global Database, and Preprint servers were searched. Using dichotomous data for all values, the risk ratios (RR) were calculated by applying the random-effects model in Review Manager 5.4.
Results: The 12 studies pooled 17,297 participants, with 8,528 patients in the colchicine group and 8,769 in the standard care group. Colchicine treatment led to a statistically significant reduction in the risk of death (RR=0.63, 95% CI=0.48-0.84, P=0.001). Moderately high heterogeneity was present among the included studies (I2=72%). While insignificant, the risk of mechanical ventilation was decreased by 12% among the colchicine group (RR=0.88, 95% CI=0.64-1.22, P=0.44).
Conclusions: While this meta-analysis finds overall reductions in mortality with colchicine treatment, these findings must be utilized with caution. Placebo-controlled randomized clinical trials are warranted at a large scale to validate the viability of colchicine as an adjuvant treatment for COVID-19. On obtaining more concrete findings, the potential role of colchicine may be better optimized in non-severe patients as well, across in-hospital and outpatient settings.
Keywords: Colchicine, COVID-19, SARS-CoV-2, clinical trials, mortality, adverse outcomes, inflammation