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Meta-Analysis
. 2021 Jul:96:107723.
doi: 10.1016/j.intimp.2021.107723. Epub 2021 Apr 27.

Colchicine and mortality in patients with coronavirus disease 2019 (COVID-19) pneumonia: A systematic review, meta-analysis, and meta-regression

Eka Noneng Nawangsih  1 , Yudith Yunia Kusmala  2 , Iis Inayati Rakhmat  3 , Dewi Ratih Handayani  4 , Henny Juliastuti  5 , Arief Wibowo  6 , Michael Anthonius Lim  7 , Raymond Pranata  8
Affiliations
Meta-Analysis

Colchicine and mortality in patients with coronavirus disease 2019 (COVID-19) pneumonia: A systematic review, meta-analysis, and meta-regression

Eka Noneng Nawangsih et al. Int Immunopharmacol. 2021 Jul.

Abstract

Objective: This systematic review, with meta-analysis and meta-regression aims to evaluate the effect of colchicine administration on mortality in patients with coronavirus disease 2019 (COVID-19) and factors affecting the association.

Methods: A systematic literature search using the PubMed, Scopus, and Embase databases were performed from inception of databases up until 3 March 2021. We included studies that fulfill all of the following criteria: 1) observational studies or randomized controlled trials (RCTs) that report COVID-19 patients, 2) reporting colchicine use, and 3) mortality within 30 days. There was no restriction on the age, inpatients or outpatients setting, and severity of diseases. The intervention was colchicine administration during treatment for COVID-19. The control was receiving placebo or standard of care. The outcome was mortality and the pooled effect estimate was reported as odds ratio (OR). Random-effects restricted maximum likelihood meta-regression was performed to evaluate factors affecting the pooled effect estimate.

Results: Eight studies comprising of 5530 patients were included in this systematic review and meta-analysis. There were three RCTs and five observational studies. Pooled analysis showed that colchicine was associated with lower mortality in patients with COVID-19 (OR 0.47 [0.31, 0.72], p = 0.001; I2: 30.9, p = 0.181). Meta-regression analysis showed that the association between colchicine and mortality was reduced by increasing age (OR 0.92 [0.85, 1.00], p = 0.05), but not gender (reference: male, p = 0.999), diabetes (p = 0.376), hypertension (p = 0.133), and CAD (p = 0.354).

Conclusion: This meta-analysis indicates that colchicine may reduce mortality in patients with COVID-19. Meta-regression analysis showed that the benefit was reduced as age increases.

Prospero: CRD42021240609.

Keywords: COVID-19; Colchicine; Coronavirus; Outcome; Treatment.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
PRISMA Flowchart.
Fig. 2
Fig. 2
Summary of Cochrane Risk of Bias Assessment.
Fig. 3
Fig. 3
Colchicine and Mortality in COVID-19.
Fig. 4
Fig. 4
Meta-regression Analysis for the Association between Colchicine and Mortality in COVID-19 using age (A), gender (B), diabetes (C), hypertension (D), and CAD (E) as covariates.
See this image and copyright information in PMC

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