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

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.

Download Full-text

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

10.1101/2021.02.02.21250960 ◽

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.

Download Full-text

Systematic review and meta-analysis of the effect of cognitive impairment on the risk of admission to long-term care after stroke

HRB Open Research ◽

10.12688/hrbopenres.13055.1 ◽

2020 ◽

Vol 3 ◽

pp. 28 ◽

Cited By ~ 1

Author(s):

Jefrey Shumba ◽

Affraic McLoughlin ◽

Lamorna Browne ◽

Alenka Schmid ◽

Maev-Ann Wren ◽

...

Keyword(s):

Systematic Review ◽

Cognitive Impairment ◽

Functional Impairment ◽

Odds Ratio ◽

Long Term Care ◽

Meta Analysis ◽

Standard Form ◽

Term Care ◽

Post Stroke

Introduction: Admission to long-term care (LTC) post-stroke can be a significant source of costs. Studies evaluating the effect of cognitive impairment (CI) and dementia on risk of LTC admission post-stroke have not been systematically reviewed. The aim of this paper was to conduct a systematic review and meta-analysis of studies of the association between post-stroke CI/dementia and admission to LTC. Patients and methods: PubMed, PsycInfo and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were searched for peer-review articles in English published January 2000-June 2018. Included studies were population-based or hospital-based studies assessing the relationship between CI or dementia, and admission to LTC post-stroke. Abstracts were screened, followed by full-text review of potentially relevant articles. Relevant data was extracted using a standard form and the Crowe Critical Appraisal Tool was used for quality appraisal. Results were pooled using random-effects meta-analysis and heterogeneity was assessed using the I² statistic. Results: 18 articles were included in the review and 12 in a meta-analysis. 14/18 studies adjusted for covariates including functional impairment. Increased odds of admission to LTC was associated with post-stroke CI [Odds Ratio (CI 95%): 2.36 (1.18, 4.71), I²=77%] and post-stroke dementia [Odds Ratio (CI 95%): 2.58 (1.38 to 4.82), I²=60%]. Discussion and conclusion: Post-stroke CI and dementia increase odds of admission to LTC post-stroke, independent of functional impairment. This indicates the potential for interventions that reduce post-stroke CI and dementia to also reduce risk of admission to LTC post-stroke, and ultimately costs.

Download Full-text

The effect of physical rehabilitation on activities of daily living in older residents of long-term care facilities: systematic review with meta-analysis

Age and Ageing ◽

10.1093/ageing/aft133 ◽

2013 ◽

Vol 42 (6) ◽

pp. 682-688 ◽

Cited By ~ 34

Author(s):

Tom Crocker ◽

John Young ◽

Anne Forster ◽

Lesley Brown ◽

Seline Ozer ◽

...

Keyword(s):

Systematic Review ◽

Activities Of Daily Living ◽

Daily Living ◽

Long Term Care ◽

Meta Analysis ◽

Physical Rehabilitation ◽

Term Care ◽

Care Facilities

Download Full-text

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

10.1101/2021.02.08.21251070 ◽

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.

Download Full-text