Effect of colchicine on the outcomes of patients with COVID-19: a systematic review and meta-analysis of randomised controlled trials

Aim This meta-analysis aimed to assess the usefulness of colchicine in patients with COVID-19. Methods PubMed, Web of Science, Ovid MEDLINE, the Cochrane Library, Embase, and Clinicaltrials.gov were searched for relevant randomised controlled trials (RCTs) published between database inception and November 12, 2021. Only RCTs that compared the clinical efficacy and safety of colchicine with other alternative treatments or placebos in patients with COVID-19 were included. Results Overall, 7 RCTs involving 16,024 patients were included; 7,794 patients were in the study group receiving colchicine and 8,230 were in the control group receiving placebo or standard treatment. The study and control groups had similar risk of mortality (odds ratio [OR], 1.00; 95% CI, 0.91-1.09; I (2) = 0%). No significant difference was observed between the study and control groups in terms of the need for non-invasive ventilation (OR, 0.92; 95% CI, 0.83-1.03; I (2) = 0%), the need for mechanical ventilation (OR, 0.64; 95% CI, 0.32-1.32; I (2) = 58%), and length of hospital stay (mean difference, -0.42 days; 95% CI, -1.95 to 1.11; I (2) = 62%). In addition, colchicine was associated with significantly higher risks of gastrointestinal adverse events (OR, 1.81; 95% CI, 1.56-2.11; I (2) = 0%) and diarrhoea (OR, 2.12; 95% CI, 1.75-2.56; I (2) = 9%). Conclusions Colchicine does not improve clinical outcomes in patients with COVID-19, so it did not support the additional use of colchicine in the treatment of patients with COVID-19. Key message Colchicine could not reduce the mortality of patients with COVID-19. No significant difference was observed between the colchicine and comparators in terms of the need for non-invasive ventilation, need for mechanical ventilation, and length of hospital stay. Colchicine was associated with a higher risk of gastrointestinal adverse events.