Immun Inflamm Dis . The effect of colchicine on mortality outcome and duration of hospital stay in patients with COVID-19: A meta-analysis of randomized trials

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Immun Inflamm Dis


. 2021 Dec 30.
doi: 10.1002/iid3.562. Online ahead of print.
The effect of colchicine on mortality outcome and duration of hospital stay in patients with COVID-19: A meta-analysis of randomized trials


Chia Siang Kow ^{1 2} , Learn-Han Lee ³ , Dinesh Sangarran Ramachandram ² , Syed Shahzad Hasan ^{4 5} , Long Chiau Ming ⁶ , Hui Poh Goh ⁶



Affiliations

• PMID: 34970856
• DOI: 10.1002/iid3.562

Abstract

Background: Overactivation of the NLR family pyrin domain containing 3 (NLRP3) inflammasome can lead to severe illness in patients with coronavirus disease-2019 (COVID-19). The NLRP3 inhibitor, colchicine, therefore, appears to be promising for the treatment of COVID-19.
Aims: We aimed to perform a meta-analysis of randomized trials investigating the effect of colchicine in patients with COVID-19.
Materials & methods: We systematically searched electronic databases and clinical trial registries (up to October 17, 2021) for eligible studies. The outcomes of interest were all-cause mortality and duration of hospital stay. Meta-analysis with the random-effects model was used to estimate the pooled odds ratio (OR) of mortality and 95% confidence interval (CI). The pooled standardized mean difference of duration of hospital stay with 95% CI between colchicine users and non-colchicine users was estimated using Cohen's d index.
Results: The meta-analyses revealed no significant difference in the odds of mortality (pooled OR = 0.76; 95% CI: 0.53-1.07), but a significant reduction in the duration of hospital stay with the use of colchicine (pooled standardized mean difference = -0.59; 95% CI: -1.06 to -0.13).
Discussion and conclusion: The ability of colchicine to reduce the length of stay in hospitalized patients with COVID-19 is consistent with its potential to prevent clinical deterioration via inhibition of NLRP3 inflammasome. Nevertheless, such beneficial effects of colchicine did not translate into mortality benefits in patients with COVID-19.

Keywords: Coronavirus disease; NLRP3 inhibitor; SARS-CoV-2; inflammasome; systematic review.