Safety and Efficacy of Colchicine in COVID-19 Treatment: Systematic Review and Meta-Analysis

Abstract

Background: Colchicine is an anti-inflammatory drug used for the treatment of gout and other autoinflammatory conditions. Several trials reported promising results of the efficacy of colchicine in Covid-19 due to its anti-inflammatory properties. However, applying these results to clinical settings remains the subject of ongoing research. Methods: We performed a systematic review and meta-analysis on the efficacy and safety of colchicine in the treatment of Covid-19. PubMed, Cochrane Library, Web of Science, and Scopus were searched for relevant studies. The primary outcomes were 28-day mortality, invasive mechanical ventilation, non-invasive mechanical ventilation, and ICU admissions. The risk ratio was used to compare effectiveness between the two groups. Subgroup analysis was done for C-reactive protein and duration of hospitalization. Results: 17 randomized controlled trials with a total of 25478 patients were included. The overall Risk ratio didn't favor any of the two groups in terms of 28-day mortality (RR = 1.03, 95 % CI [0.93:1.15], P = 0.58), non-invasive mechanical ventilation (RR = 0.81, 95 % CI [0.44:1.48], P = 0.49), ICU admission (RR = 0.89, 95 % CI [0.56:1.41], P = 0.62). The overall mean difference (MD) did not show statistical significance between both groups in terms of C- reactive protein (CRP) (mg/dl) (MD = −1.21, 95 % CI [-2.42:0.01], P = 0.05), lactate dehydrogenase (LDH) (U/L) (MD = 50.95, 95 % CI [-92.07: 193.98], Ferritin (ng/ml) (MD = 128.08, 95 % CI [51.97:204.18], P = 0.001), ICU length of stay (MD = −0.09, 95 % CI [-0.34:0.15], P = 0.45) and duration of hospitalization (MD = −0.41, 95 % CI [-1.56:0.73], P = 0.48). Conclusion: In Covid-19 treatment, colchicine didn't result in significant benefits in terms of clinical outcomes. More large-scale randomized clinical trials with standardized dosages and long-term follow-up are needed for further investigation into the colchicine effect. © 2025 Elsevier B.V., All rights reserved.