臨床感染症と実践

抽象的な

Colchicine and Covid-19: Could there still be Hope for this Old Low-Cost Drug?: Multicenter Observational Study in Hospitalized Patients

Elena Villamanan, Carmen Sobrino, Carlos Carpio, Carmen Mateos, Yolanda Larrubia, Ester Zamarrpon, Eduardo Armada, Almudena Castro, Jesus Llorente, Alicia Martinez, Jorge Gomez-Cerezo, Alicia Herrero, Rodolfo Alvarez-Sala

Background: Usefulness of colchicine in hospitalized COVID-19 patients with pneumonia has been compared with standard of care (SOC) in several studies around the world with many different results. Taken on account the variability of patient’s characteristics and their SOC according to the country, we carried out the following analysis in order to contribute with more data to the knowledge of this treatment.

Objective: To evaluate whether treatment with colchicine reduced the rate of death in COVID-19 hospitalized patients.Length of stay, differences in response by sex and age, response to colchicine according to inflammatory markers, comorbidity and concomitant drugs prescribed to treat these patients were also analyzed.

Methods: Real-world, controlled, retrospective study carried out in two tertiary hospitals in Spain. Outcomes werecompared in patients who received colchicine (colchicine group-CG) with those inpatients who did not (non-colchicine group-NCG). Controls were matched to the CG 1:1 by age (±2 years), sex and severity of the disease.

Results: 222 patients were evaluated (111 treated with colchicine), median age 79 years (66-87). There were 19(17.1%) deaths in the CG and in 32(29.4%) in the NCG (OR: 0.497;95%CI:0.261–0.946;p=0.031). A longer hospital stays in CG with respect to NCG (13[7-20] vs. 10 [6-15], respectively; p=0.019) was observed. Proportion of deaths were significantly higher in the NCG than in CG in patients≥ 70years (p=0.012). A greater benefit of colchicine treatment was detected for men even though our data did not reach significant differences. There were differences in deaths between the CG and NCG in patients with CRP high levels (p=0.046). 88.7% of patients had comorbidities, most frequently systemic hypertension, diabetes, COPD and cardiovascular disease, with no differences in deaths between both groups. Almost all patients received antimicrobials (91.9%) concomitantly, mainly azithromycin and ceftriaxone.We found differences in death rate between two groups in patients using antibiotics (38% in CG vs. 62% in NCG) (p=0.023).

Conclusion: Our findings support that colchicine may reduce mortality in COVID-19 hospitalized patients with pneumonia. These results indicate that, despite the available data, more RCTs are still needed in order to identify which patients hospitalized for COVID-19 pneumonia may benefit from this safe and inexpensive drug.