Impact of colchicine on mortality and morbidity in COVID-19: a systematic review

被引:10
|
作者
Sanghavi, Devang [1 ]
Bansal, Pankaj [2 ]
Kaur, Ikwinder Preet [3 ]
Mughal, Mohsin Sheraz [3 ]
Keshavamurthy, Chandana [4 ]
Cusick, Austin [5 ]
Schram, Jennifer [6 ]
Yarrarapu, Siva Naga S. [7 ]
Giri, Abhishek R. [1 ]
Kaur, Nirmaljot [8 ]
Franco, Pablo Moreno [1 ]
Abril, Andy [9 ]
Aslam, Fawad [10 ]
机构
[1] Mayo Clin Florida, Dept Crit Care Med, Jacksonville, FL USA
[2] Mayo Clin Hlth Syst, Dept Rheumatol, Eau Claire, WI USA
[3] Rutgers Monmouth Med Ctr, Dept Internal Med, Long Branch, NJ USA
[4] Ochsner Med Ctr, Dept Rheumatol, New Orleans, LA USA
[5] Riverside Methodist Hosp, Dept Internal Med, Columbus, OH 43214 USA
[6] Mayo Clin Hlth Syst, Mayo Clin Lib Wisconsin, Eau Claire, WI USA
[7] Monmouth Med Ctr, Dept Internal Med, RWJ Barnabas Hlth, Long Branch, NJ USA
[8] Univ Calif Riverside, Riverside Sch Med, Dept Internal Med, Riverside, CA 92521 USA
[9] Mayo Clin Florida, Dept Rheumatol, Jacksonville, FL USA
[10] Mayo Clin Arizona, Dept Rheumatol, 13400 E Shea Blvd, Scottsdale, AZ 85259 USA
关键词
Colchicine; COVID-19; Coronavirus;
D O I
10.1080/07853890.2021.1993327
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Introduction Colchicine, because of its anti-inflammatory and possible anti-viral properties, has been proposed as potential therapeutic option for COVID-19. The role of colchicine to mitigate "cytokine storm" and to decrease the severity and mortality associated with COVID-19 has been evaluated in many studies. Objective To evaluate the role of colchicine on morbidity and mortality in COVID-19 patients. Methods This systematic review was conducted in accordance with the PRISMA recommendations. The literature search was conducted in 6 medical databases from inception to February 17, 2021 to identify studies evaluating colchicine as a therapeutic agent in COVID-19. All included studies were evaluated for risk of bias (ROB) using the Revised Cochrane ROB tool for randomised controlled trials (RCTs) and Newcastle-Ottawa Scale (NOS) for case-control and cohort studies. Results Four RCTs and four observational studies were included in the final analysis. One study evaluated colchicine in outpatients, while all others evaluated inpatient use of colchicine. There was significant variability in treatment protocols for colchicine and standard of care in all studies. A statistically significant decrease in all-cause mortality was observed in three observational studies. The risk of mechanical ventilation was significantly reduced only in one observational study. Length of hospitalisation was significantly reduced in two RCTs. Risk for hospitalisation was not significantly decreased in the study evaluating colchicine in outpatients. Very few studies had low risk of bias. Conclusion Based on the available data, colchicine shall not be recommended to treat COVID-19. Further high-quality and multi-center RCTs are required to assess the meaningful impact of this drug in COVID-19. KEY MESSAGES Colchicine, an anti-inflammatory agent has demonstrated anti-viral properties in in-vitro studies by degrading the microtubules, as well as by inhibiting the production of pro-inflammatory cytokines. Colchicine has been studied as a potential therapeutic option for COVID-19, with variable results. Until further research can establish the efficacy of colchicine in COVID-19, the use of colchicine in COVID-19 shall be restricted to clinical trials.
引用
收藏
页码:775 / 789
页数:15
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