Association between treatment with colchicine and improved survival in a single-centre cohort of adult hospitalised patients with COVID-19 pneumonia and acute respiratory distress syndrome

Mirko Scarsi, Silvia Piantoni, Enrico Colombo, Paolo Airó, Donata Richini, Marco Miclini, Valeria Bertasi, Marta Bianchi, Damiano Bottone, Patrizia Civelli, Maria-Sofia Cotelli, Ezio Damiolini, Gloria Galbassini, Diego Gatta, Maria-Laura Ghirardelli, Roberto Magri, Paola Malamani, Monia Mendeni, Stefano Molinari, Andrea Morotti, Luisa Salada, Marinella Turla, Angiola Vender, Angela Tincani, Antonio Brucato, Franco Franceschini, Roberto Furloni, Laura Andreoli, Mirko Scarsi, Silvia Piantoni, Enrico Colombo, Paolo Airó, Donata Richini, Marco Miclini, Valeria Bertasi, Marta Bianchi, Damiano Bottone, Patrizia Civelli, Maria-Sofia Cotelli, Ezio Damiolini, Gloria Galbassini, Diego Gatta, Maria-Laura Ghirardelli, Roberto Magri, Paola Malamani, Monia Mendeni, Stefano Molinari, Andrea Morotti, Luisa Salada, Marinella Turla, Angiola Vender, Angela Tincani, Antonio Brucato, Franco Franceschini, Roberto Furloni, Laura Andreoli

Abstract

Objectives: The outbreak of COVID-19 posed the issue of urgently identifying treatment strategies. Colchicine was considered for this purpose based on well-recognised anti-inflammatory effects and potential antiviral properties. In the present study, colchicine was proposed to patients with COVID-19, and its effects compared with 'standard-of-care' (SoC).

Methods: In the public hospital of Esine, northern Italy, 140 consecutive inpatients, with virologically and radiographically confirmed COVID-19 admitted in the period 5-19 March 2020, were treated with 'SoC' (hydroxychloroquine and/or intravenous dexamethasone; and/or lopinavir/ritonavir). They were compared with 122 consecutive inpatients, admitted between 19 March and 5 April 2020, treated with colchicine (1 mg/day) and SoC (antiviral drugs were stopped before colchicine, due to potential interaction).

Results: Patients treated with colchicine had a better survival rate as compared with SoC at 21 days of follow-up (84.2% (SE=3.3%) vs 63.6% (SE=4.1%), p=0.001). Cox proportional hazards regression survival analysis showed that a lower risk of death was independently associated with colchicine treatment (HR=0.151 (95% CI 0.062 to 0.368), p<0.0001), whereas older age, worse PaO2/FiO2, and higher serum levels of ferritin at entry were associated with a higher risk.

Conclusion: This proof-of-concept study may support the rationale of use of colchicine for the treatment of COVID-19. Efficacy and safety must be determined in controlled clinical trials.

Keywords: anti-inflammatory agents, non-steroidal; antirheumatic agents; communicable diseases, imported; inflammation; therapeutics.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1
Figure 1
Survival rate in patients treated with colchicine as compared with the ’standard-of-care‘ (SoC) group.

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