Efficacy of colchicine with or without corticosteroids in hospitalized COVID-19 patients: A systematic review and meta-analysis

BackgroundColchicine, an anti-inflammatory drug, was used early in the COVID-19 pandemic for its ability to modulate the inflammatory response. However, its clinical efficacy in hospitalized patients, particularly when used alongside corticosteroids, remains unclear. This systematic review and meta-analysis assessed colchicines efficacy in hospitalized COVID-19 patients. MethodsWe searched PubMed, Web of Science, and EMBASE databases for randomized controlled trials (RCTs) evaluating colchicine in hospitalized adults with moderate-to-severe COVID-19. Risk of bias was assessed using the Cochrane tool. A random-effects model was used for meta-analysis, and heterogeneity was assessed using the I{superscript 2} statistic. ResultsThirteen RCTs involving 16,529 participants were included in the meta-analysis. Colchicine did not significantly reduce overall mortality (Risk Difference (RD) = -0.02, 95% Confidence Interval (CI): [-0.04, 0.00]), ICU admissions (RD = -0.03, 95% CI: [-0.06, 0.01]), mechanical ventilation rates (RD = -0.01, 95% CI: [-0.02, 0.00]), hospitalization duration (Mean Difference (MD) = -0.58 days, 95% CI: [-1.80, 0.64]), or ICU length of stay (MD = -1.41 days, 95% CI: [-3.35, 0.53]), although in every comparison colchicine treated groups had a greater positive effect. Subgroup analysis showed a significant reduction in mortality among patients who received colchicine in the absence of corticosteroids (RD = -0.07, 95% CI: [-0.11, -0.03]), whereas no significant effect was observed in patients treated with colchicine and corticosteroids. ConclusionsWhile colchicine did not improve outcomes in the overall population, it showed benefits in COVID-19 patients not receiving corticosteroids. These findings suggest a potential role for colchicine in targeted clinical settings. GRAPHICAL ABSTRACT O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=113 SRC="FIGDIR/small/25325283v1_ufig1.gif" ALT="Figure 1"> View larger version (45K): org.highwire.dtl.DTLVardef@1b0eb57org.highwire.dtl.DTLVardef@2ad1f0org.highwire.dtl.DTLVardef@13cebdaorg.highwire.dtl.DTLVardef@a06c36_HPS_FORMAT_FIGEXP M_FIG C_FIG