The role of colchicine in the treatment of patients with covid19 Hospitalized in the intensive care unit

Abstract

In patients with Covid-19, high levels of IL-1, IL-6, and TNFα increase in severe disease cases, which can cause cytokine storm and lung damage in the form of ARDS. Colchicine is a drug used to treat acute gout, familial Mediterranean fever, and pericarditis. This drug exerts its anti-inflammatory effect by inhibiting neutrophils and reducing IL-1 and IL-6, and it also has antiviral properties. The aim of the current study is to evaluate the role of colchicine in the treatment of Covid-19 patients hospitalized in the intensive care unit. Materials and Methods: In this RCT study, after the approval of the plan in the Anesthesiology Research Team and the approval of the University Ethics Committee and obtaining informed consent from the patient or their companions, patients who were diagnosed with COVID-19 (with positive PCR or clinical evidence and positive lung CT) were admitted to the General ICU department of Imam Reza Hospital in Tabriz and were placed in two groups A and B. Group A patients were given usual treatment and placebo, and group B patients were given usual treatment plus colchicine tablets in the amount of 1 mg loading and 0.5 mg morning and night for 10 days. Demographic characteristics, vital signs and ABG were daily obtained at the beginning of the study. The length of stay in ICU, intubation and duration of mechanical ventilation and mortality, LDH, CRP were obtained at the beginning and 5 and 10 days later. Findings: The average age of the patients was 50.44 ± 17.97 years with a median of 49 years. The minimum age of the patients was 23 years and the maximum was 79 years. Among the 80 examined patients, 56 cases (70%) were male and 24 cases (30%) were female. There was no difference between the two groups in terms of vital signs during ICU admission. There was no difference between the two groups in terms of LDH and CRP values at the beginning of hospitalization, but on the 5th and 10th days of hospitalization, the LDH and CRP values in the colchicine group were significantly lower than the placebo group. Significantly, the duration of hospitalization in the ICU and the duration of mechanical ventilation were less in the colchicine group than in the placebo group. Also, the mortality rate in patients receiving colchicine is significantly lower than the placebo group (35.7% versus 50%; p=0.004).