Repurposing Colchicine for the Management of COVID-19: A Systematic Review and Meta-analysis

  1. Rashmi Ranjan Mohanty
  2. Bikash Ranjan Meher
  3. Biswa Mohan Padhy
  4. Smita Das

Reviewed by

Read the full article

Listed in

Log in to save this article

Abstract

Many anti-inflammatory drugs like, tocilizumab, N-acetylcystiene and etolizumab has been repurposed for the management of COVID-19 with variable success. Colchicine exhibits anti-inflammatory activity by tubulin disruption and inhibition of leucocyte-mediated inflammatory activities like production of superoxide and release of various cytokines which are central to the pathophysiology of COVID-19. So, this systematic review and meta-analysis assessed the currently available data on the use of colchicine for the treatment of COVIDLJ19. A total of 3 studies (2 RCTS and 1 observational study) including 402 patients were included out of which 194 patients received colchicine. The random effect model showed the overall pooled OR to be 0.32 (95%CI: 0.18 to 0.56) for the primary outcome (Clinical deterioration) which was statistically significant (p <0.0001). Also there was increase in adverse effect (diarrhoea) with use of colchicine as suggested by the pooled OR (OR=4.56, 95%CI: 2.04 to 10.15, P=0.0002). With the limited number of available studies, it has shown statistically significant reduction in clinical deterioration in COVID-19. Though there was an increase in adverse effect in the form of diarrhoea, it was mild and self-limiting.

Article activity feed

  1. ScreenIT

    SciScore for 10.1101/2021.02.17.21251884: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Outcome measures: Information source: PubMed, EMBASE, the Cochrane Library, SCOPUS, and Web of Science were searched for articles on colchicine therapy in COVID 19 from inception till September 15, 2020.
    PubMed
    suggested: (PubMed, RRID:SCR_004846)
    EMBASE
    suggested: (EMBASE, RRID:SCR_001650)
    Cochrane Library
    suggested: (Cochrane Library, RRID:SCR_013000)
    For unpublished data, we checked the International Clinical Trials Registry Platform (ICTRP), which is a central database containing trial registration data sets provided by the different international trial registries including ClinicalTrials.gov.
    ClinicalTrials
    suggested: (ClinicalTrials.gov, RRID:SCR_002309)
    Pre-print server medRxiv and bioRxiv were also searched for pre-print data.
    bioRxiv
    suggested: (bioRxiv, RRID:SCR_003933)
    Data extraction and management: Three review authors (RRM, BRM, SD) independently extracted and assessed the quality of data using the predefined eligibility criteria following Cochrane Collaboration’s guidelines.
    Cochrane Collaboration’s
    suggested: None
    Data analysis: Cochrane Program Review Manager 5.3 software was used for the Meta-analysis.
    Cochrane Program
    suggested: None
    For dichotomous values, odd’s ratio (OR) and 95% confidence interval was expressed in accordance with Cochrane Handbook for Systematic Reviews of Interventions.
    Cochrane Handbook
    suggested: None

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Limitations: The study has certain limitations. The number of included studies and the pooled sample size is less. Among them, one study is observational in nature and carries the risk of confounding and other biases. One of the RCTs included was open label and may have inherent assessment bias. The overall risk of bias in all studies ranged from some concern to serious and the quality of evidence is low. Additionally, there was variability in the follow up period between the studies ranging from 7 to 21 days.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2021.02.17.21251884v1 on medRxiv