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Ann Rheum Dis ; 79(10): 1286-1289, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32732245

RESUMEN

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.


Asunto(s)
Antiinflamatorios/uso terapéutico , Colchicina/uso terapéutico , Infecciones por Coronavirus/tratamiento farmacológico , Neumonía Viral/tratamiento farmacológico , Síndrome de Dificultad Respiratoria/tratamiento farmacológico , Anciano , Anciano de 80 o más Años , Antivirales/uso terapéutico , Betacoronavirus , COVID-19 , Estudios de Casos y Controles , Estudios de Cohortes , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/mortalidad , Dexametasona/uso terapéutico , Combinación de Medicamentos , Inhibidores Enzimáticos/uso terapéutico , Femenino , Hospitalización , Humanos , Hidroxicloroquina/uso terapéutico , Italia , Lopinavir/uso terapéutico , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/mortalidad , Prueba de Estudio Conceptual , Modelos de Riesgos Proporcionales , Síndrome de Dificultad Respiratoria/etiología , Síndrome de Dificultad Respiratoria/mortalidad , Ritonavir/uso terapéutico , SARS-CoV-2 , Tasa de Supervivencia , Tratamiento Farmacológico de COVID-19
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