scholarly journals Colchicine use in patients with COVID-19: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Leonard Chiu ◽  
Ronald Chow ◽  
Nicholas Chiu ◽  
Chun-Han Lo ◽  
Rahul Aggarwal ◽  
...  
Keyword(s):  
Systematic Review ◽  
Odds Ratio ◽  
Lower Risk ◽  
Observational Studies ◽  
Trial Design ◽  
Meta Analysis ◽  
Point Estimate ◽  
Randomized Controlled ◽  
Risk Of Mortality ◽  
Prospective Investigation

ABSTRACTIntroductionColchicine may inhibit inflammasome signaling and reduce proinflammatory cytokines, a purported mechanism of COVID-19 pneumonia. The aim of this systematic review and meta-analysis is to report on the state of the current literature on the use of colchicine in COVID-19 and to investigate the reported clinical outcomes in COVID-19 patients by colchicine usage.MethodsThe literature was searched from January 2019 through January 28, 2021. References were screened to identify studies that reported the effect of colchicine usage on COVID-19 outcomes including mortality, intensive care unit (ICU) admissions, or mechanical ventilation. Studies were meta-analyzed for mortality by the subgroup of trial design (RCT vs observational) and ICU status. Studies reporting an odds ratio (OR) and hazard ratio (HR) were analyzed separately.ResultsSix studies, reporting on 5,033 patients, were included in this review. Across the six studies, COVID-19 patients who had colchicine had a lower risk of mortality – HR of 0.25 (95% CI: 0.09, 0.66) and OR of 0.36 (95% CI: 0.17, 0.76). Among the three observational studies, COVID-19 patients who received colchicine had a lower risk of mortality – HR of 0.25 (95% CI: 0.09, 0.66) and OR of 0.21 (95% CI: 0.06, 0.71). Among three randomized controlled trials, the summary point estimate suggests a direction toward benefit in mortality that is not statistically significant among patients receiving colchicine versus placebo– OR of 0.49 (95% CI: 0.20, 1.24).ConclusionColchicine may reduce the risk of mortality in individuals with COVID-19. Further prospective investigation is warranted to determine the efficacy of colchicine as treatment in COVID-19 patients in various care settings of the disease.

scholarly journals Colchicine use in patients with COVID-19: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261358
Author(s):  
Leonard Chiu ◽  
Chun-Han Lo ◽  
Max Shen ◽  
Nicholas Chiu ◽  
Rahul Aggarwal ◽  
...  
Keyword(s):  
Systematic Review ◽  
Odds Ratio ◽  
Lower Risk ◽  
Trial Design ◽  
Long Term Care ◽  
Meta Analysis ◽  
Term Care ◽  
Risk Of Mortality ◽  
Prospective Investigation

Introduction Colchicine may inhibit inflammasome signaling and reduce proinflammatory cytokines, a purported mechanism of COVID-19 pneumonia. The aim of this systematic review and meta-analysis is to report on the state of the current literature on the use of colchicine in COVID-19 and to investigate the reported clinical outcomes in COVID-19 patients by colchicine usage. Methods The literature was searched from January 2019 through January 28, 2021. References were screened to identify studies that reported the effect of colchicine usage on COVID-19 outcomes including mortality, intensive care unit (ICU) admissions, or mechanical ventilation. Studies were meta-analyzed for mortality by the subgroup of trial design (RCT vs observational) and ICU status. Studies reporting an risk ratio (RR), odds ratio (OR) and hazard ratio (HR) were analyzed separately. Results Eight studies, reporting on 16,248 patients, were included in this review. The Recovery trial reported equivalent mortality between colchicine and non-colchicine users. Across the other studies, patients who received colchicine had a lower risk of mortality—HR of 0.25 (95% CI: 0.09, 0.66) and OR of 0.22 (95% CI: 0.09, 0.57). There was no statistical difference in risk of ICU admissions between patients with COVID-19 who received colchicine and those who did not–OR of 0.26 (95% CI: 0.06, 1.09). Conclusion Colchicine may reduce the risk of mortality in individuals with COVID-19. Further prospective investigation may further determine the efficacy of colchicine as treatment in COVID-19 patients in various care settings of the disease, including post-hospitalization and long-term care.

scholarly journals The protective association between statins use and adverse outcomes among COVID-19 patients: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Ronald Chow ◽  
James Im ◽  
Nicholas Chiu ◽  
Leonard Chiu ◽  
Rahul Aggarwal ◽  
...  
Keyword(s):  
Systematic Review ◽  
Odds Ratio ◽  
Lower Risk ◽  
Meta Analysis ◽  
Adverse Outcomes ◽  
Risk Of Mortality ◽  
Before And After ◽  
Statin Usage ◽  
Similar Risk ◽  
Ventilation Studies

ABSTRACTIntroductionStatins may reduce a cytokine storm, which has been hypothesized as a possible mechanism of severe COVID-19 pneumonia. The aim of this study was to conduct a systematic review and meta-analysis to report on adverse outcomes among COVID-19 patients by statin usage.MethodsLiteratures were searched from January 2019 to December 2020 to identify studies that reported the association between statin usage and adverse outcomes, including mortality, ICU admissions, and mechanical ventilation. Studies were meta-analyzed for mortality by the subgroups of ICU status and statin usage before and after COVID-19 hospitalization. Studies reporting an odds ratio (OR) and hazard ratio (HR) were analyzed separately.ResultsThirteen cohorts, reporting on 110,078 patients, were included in this meta-analysis. Individuals who used statins before their COVID-19 hospitalization showed a similar risk of mortality, compared to those who did not use statins (HR 0.80, 95% CI: 0.50, 1.28; OR 0.62, 95% CI: 0.38, 1.03). Patients who were administered statins after their COVID-19 diagnosis were at a lower risk of mortality (HR 0.53, 95% CI: 0.46, 0.61; OR 0.57, 95% CI: 0.43, 0.75). The use of statins did not reduce the mortality of COVID-19 patients admitted to the ICU (OR 0.65; 95% CI: 0.26, 1.64). Among non-ICU patients, statin users were at a lower risk of mortality relative to non-statin users (HR 0.53, 95% CI: 0.46, 0.62; OR 0.64, 95% CI: 0.46, 0.88).ConclusionPatients administered statins after COVID-19 diagnosis or non-ICU admitted patients were at lower risk of mortality relative to non-statin users.

scholarly journals The protective association between statins use and adverse outcomes among COVID-19 patients: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253576
Author(s):  
Ronald Chow ◽  
James Im ◽  
Nicholas Chiu ◽  
Leonard Chiu ◽  
Rahul Aggarwal ◽  
...  
Keyword(s):  
Systematic Review ◽  
Odds Ratio ◽  
Lower Risk ◽  
Meta Analysis ◽  
Adverse Outcomes ◽  
Risk Of Mortality ◽  
Before And After ◽  
Statin Usage ◽  
Similar Risk ◽  
Ventilation Studies

Introduction Statins may reduce a cytokine storm, which has been hypothesized as a possible mechanism of severe COVID-19 pneumonia. The aim of this study was to conduct a systematic review and meta-analysis to report on adverse outcomes among COVID-19 patients by statin usage. Methods Literatures were searched from January 2019 to December 2020 to identify studies that reported the association between statin usage and adverse outcomes, including mortality, ICU admissions, and mechanical ventilation. Studies were meta-analyzed for mortality by the subgroups of ICU status and statin usage before and after COVID-19 hospitalization. Studies reporting an odds ratio (OR) and hazard ratio (HR) were analyzed separately. Results Thirteen cohorts, reporting on 110,078 patients, were included in this meta-analysis. Individuals who used statins before their COVID-19 hospitalization showed a similar risk of mortality, compared to those who did not use statins (HR 0.80, 95% CI: 0.50, 1.28; OR 0.62, 95% CI: 0.38, 1.03). Patients who were administered statins after their COVID-19 diagnosis were at a lower risk of mortality (HR 0.53, 95% CI: 0.46, 0.61; OR 0.57, 95% CI: 0.43, 0.75). The use of statins did not reduce the mortality of COVID-19 patients admitted to the ICU (OR 0.65; 95% CI: 0.26, 1.64). Among non-ICU patients, statin users were at a lower risk of mortality relative to non-statin users (HR 0.53, 95% CI: 0.46, 0.62; OR 0.64, 95% CI: 0.46, 0.88). Conclusion Patients administered statins after COVID-19 diagnosis or non-ICU admitted patients were at lower risk of mortality relative to non-statin users.

scholarly journals Repurposing Colchicine in Treating Patients with COVID-19: A Systematic Review and Meta-Analysis

Life ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 864
Author(s):  
Chi-Hone Lien ◽  
Ming-Dar Lee ◽  
Shun-Long Weng ◽  
Chao-Hsu Lin ◽  
Lawrence Yu-Min Liu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Subgroup Analysis ◽  
Lower Risk ◽  
Meta Analysis ◽  
Colchicine Treatment ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Risk Of Mortality ◽  
Significant Difference

Coronavirus disease 2019 (COVID-19) had caused huge health losses worldwide. Several drugs had been applied to treat patients with COVID-19, and repurposing colchicine had been proposed for its anti-inflammatory properties via several pathways. In this systematic review, we evaluated the effects of colchicine treatment. From inception to May 31, 2021, databases, including PubMed, EMbase, medRxiv, and Research Square were searched, and 11 studies were enrolled. A total of 17,205 COVID-19 patients with male predominance (62.9%) were analyzed. Patients with colchicine treatment had a significantly lower risk of mortality (odds ratio (OR): 0.57, 95% confidence interval (CI): 0.38–0.87, I2: 72%; p < 0.01) and a non-significantly lower rate of mechanical ventilation (OR: 0.67, 95%CI: 0.39–1.15). The side effects were mild and not significantly different (OR: 2.03, 95%CI: 0.51–8.09). Subgroup analysis with randomized controlled trials showed no statistically significant difference in the mortality (OR: 0.80, 95%CI: 0.44–1.46, I2: 33%; p = 0.22). In conclusion, our meta-analysis found that colchicine treatment was associated with a significantly lower risk of mortality in patients with COVID-19. However, this benefit was not observed in the subgroup analysis of randomized controlled trials. Further randomized controlled studies are required to confirm the potential benefits of colchicine treatment.

scholarly journals Profile and frequency of antiparkinsonian drugs adverse reactions: a systematic review and meta-analysis

2021 ◽  
Vol 13 (3) ◽  
pp. 75-81
Author(s):  
A. A. Tappakhov ◽  
T. E. Popova ◽  
A. I. Vasilev ◽  
T. G. Govorova ◽  
Yu. I. Khabarova ◽  
...  
Keyword(s):  
Systematic Review ◽  
Odds Ratio ◽  
Adverse Reactions ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Drug Reactions ◽  
Randomized Controlled ◽  
The Relationship ◽  
Ci Calculation ◽  
Antiparkinsonian Drugs

Objective: to assess the predictors and prevalence of adverse drug reactions (ADRs) associated with antiparkinsonian drugs.Materials and methods. 18 clinical studies and randomized controlled trials were included in the analysis. We combined all registered ADRs for each drug and made direct comparisons with odds ratio (OR) and 95% confidence interval (95% CI) calculation.Results and discussion. Levodopa/benserazide (LB) had the best safety profile among levodopa drugs. Levodopa/carbidopa (LC) compared with LB was associated with more frequent development of nausea (OR=2.8; 95% CI: 1.51–5.21), aggravation of parkinsonism (OR=4.44; 95% CI: 2.12–9.28) and dizziness (OR=3.32; 95% CI: 1.5–7.33; p=0.002). Piribedil had the lowest number of ADRs among dopamine receptor agonists. Dizziness was more common with pramipexole and ropinirole than with levodopa (OR=1.82; 95% CI: 1.21–2.74 and OR=1.65; 95% CI: 1.11–2.44 respectively). Increased daytime sleepiness and peripheral edema have also been associated with pramipexole. Arterial hypertension was present in 9.6% of patients prescribed with piribedil. Amantadine compared with pramipexole was associated with a higher risk of hallucinations (OR=2.27; 95% CI: 1.24–4.12) and constipation (OR=2.40; 95% CI: 1.14–5.05). Patients prescribed with selegeline had higher odds of dizziness (OR=3.40; 95% CI: 1.76–6.55) and hallucinations (OR=4.30; 95% CI: 1.83–10.09) compared to rasagiline.Conclusion. Based on the results, we propose a diagram of the relationship between ADRs and their frequency with antiparkinsonian drugs. We hope that the study will find clinical application and allow neurologists to consider the effectiveness and the expected risks of ADRs in the treatment of PD.

Sign in / Sign up

Export Citation Format

Share Document