Does Colchicine have an effect on Cardiac biomarkers in hospitalized patients with COVID-19?

The coronavirus disease 2019 (COVID-19) has evolved into a global pandemic, infecting over 10 million people with the disease, and killing almost 581,316 people worldwide. As scientists, doctors, and medical researchers continue to seek a cure, among other answers about epidemiology, spread, and more, they also continue to seek out therapeutic treatments to help with acute respiratory distress syndrome.

Early data about COVID-19 revealed this disease can often result in an inflammatory response that affects the respiratory system and can lead to long-lasting or fatal lung injury or respiratory distress.

As part of that journey for therapeutic treatment, it was suggested that low-dose colchicine could combine the anti-inflammatory action needed to help increase the safety profile of those with COVID-19 as opposed to just offering standard care.

This study, published in the JAMA Network in 2020, was created to evaluate the effect of colchicine on both inflammatory and cardiac biomarkers as well as the clinical outcomes of in-hospital patients diagnosed with COVID-19.

The Study: Understanding the Methodology

In order to best test the theory that low-dose colchicine could safely provide anti-inflammatory action that could assist with the severe acute respiratory syndrome infection from COVID-19, researchers used an open-label, randomized clinical trial.

They used 105 hospitalized patients (with COVID-19) and randomized them in a 1:1 allocation for 24 days in April 2020, with either standard medical treatment or colchicine with standard medical treatment.

This study, which took place in 16 tertiary hospitals in Greece), utilized a 1.5-mg loading dose of colchicine followed by .5 mg after an hour. Then, they followed up with maintenance doses of .5 mg twice every day. For one group, they combined this with standard medical treatment for three weeks. 

Ultimately, the endpoints researchers were seeking were maximum high-sensitivity cardiac troponin levels, time for C-reactive protein to reach more than 3 times the upper reference limit, and the time to deterioration.

Of the 105 patients who were evaluated, 50 were in the randomized control group and 55 received standard care in addition to colchicine.

In the control group, the mean event-free survival time was about 18.6 days. In the other group—the group receiving both standard care in addition to colchicine had a mean event-free survival time of about 20 days.

The Results & Outcomes of the Randomized Clinical Trails

Ultimately, in this randomized clinical trial, those 55 participants who received colchicine observed a substantial and statistically significantly improved time to clinical deterioration.

That being said, there was no significant difference in high-sensitivity cardiac troponin or C-reactive protein levels.

It is highly suggested that these findings be treated and interpreted with caution.