In a new study, researchers found that colchicine, a cheap drug normally used to treat gout, helps to cut the need for oxygen therapy and hospital stay in COVID-19 patients.
They suggest that although it’s not possible to confirm whether colchicine can alter the risk of death, it may nevertheless be worth adding it to standard treatment for hospital patients with moderate to severe COVID-19 infection.
The research was conducted by a team at the University of Sao Paulo.
Colchicine has been successfully used to treat and prevent systemic inflammatory conditions, including gout; systemic inflammation is a cardinal feature of moderate to severe COVID-19 infection.
The researchers wanted to find out if adding it to standard treatment might reduce the need for supplemental oxygen, length of hospital stay, including in intensive care, and risk of death in patients with moderate to severe COVID-19 infection.
The moderate disease was defined as fever, breathing difficulties, and pneumonia; severe disease was defined as all of the above, plus a rapid breathing rate of 30 or more times a minute and low levels of oxygen in the body.
In the study, the team assigned 75 patients with moderate to severe COVID-19 infection to receive either standard treatment plus 0.5 mg colchicine three times a day for 5 days, followed by the same dose twice a day for 5 days, or standard treatment plus a dummy (placebo) drug.
Standard treatment comprised doses of the antibiotic azithromycin, the antimalarial hydroxychloroquine, and the blood thinner heparin, plus a steroid (methylprednisolone) if the need for supplemental oxygen was considerable—equal to 6 litres/minute or more—and intensive care required.
The team found the average length of time patients needed oxygen therapy was 4 days for those treated with additional colchicine compared with 6.5 days for those in the standard treatment plus placebo group.
Similarly, the average length of hospital stay was 7 days for the colchicine group compared with 9 for the standard treatment group.
By day 7, fewer than 1 in 10 (9%) of those treated with colchicine needed maintenance oxygen compared with more than 4 out of 10 (42%), in the standard treatment group.
Two patients died, both of whom were in the placebo group.
Overall, colchicine was safe and well-tolerated, with few side effects; diarrhea was more common in those taking colchicine.
The team says that colchicine may have some direct antiviral properties. It may also lessen the body’s inflammatory response and help ward off damage to the cells lining vessel walls (endothelial cells).
Reductions in the need for oxygen therapy and length of hospital stay are not only good for patients but they cut healthcare costs and the need for hospital beds, added to which colchicine is not an expensive drug.
The study is published in RMD Open.