Nathaniel Dismang, BS, MS
University of Kansas Health System
Kansas City, Kansas
Disclosure information not submitted.
Usman Nazir, MD
University of Kansas Health System
Kansas City, Kansas
Disclosure information not submitted.
Xiaosong Shi, MS
Medical Statistician
University of Kansas Medical Center, United States
Disclosure information not submitted.
Title: Colchicine In The Prevention of ARDS In Hospitalized Covid 19 Patients: A Retrospective Analysis
Introduction/Hypothesis: The repurposing of medications has been an important strategy in combatting the SARS-CoV2 pandemic. Many COVID19 patients develop Acute Respiratory Distress Syndrome (ARDS), resulting from an uncontrolled inflammatory response to infection. The primary aim of this study was to observe the efficacy of the immunomodulatory drug, colchicine, in preventing the development of ARDS in hospitalized COVID19 patients.
Methods: Retrospective analysis was performed on 54 patients treated with colchicine prior to, or during hospitalization and were identified using the Society of Critical Care Medicine COVID19 registry, VIRUS. Identified patients and controls were matched through a propensity score method. The primary endpoint, development of ARDS, and secondary endpoints, hospital discharge status, 28-day mortality, and mechanical ventilation were analyzed.
Results: Of the 54 patients treated with colchicine, 8 developed ARDS, while 2 developed ARDS in the control group (14.81% vs 3.70%; P=0.05; odds ratio [OR] 4.52 [95% confidence interval {CI} 0.91-22.38]). Eleven cases and 10 controls required invasive mechanical ventilation (20.37% vs 18.52%; P=0.81; OR 1.13 [95% CI 0.43-2.92]). Zero cases and 11 controls required non-invasive mechanical ventilation (0% vs 20.37%; P < 0.01). At hospital discharge, 7 and 3 patients in the case and control groups respectively were deceased (12.96% vs 5.56%; P=0.18; OR 2.53 [95% CI 0.62-10.36]). 28-day mortality was reported for 37 cases and 33 controls, with each group having one mortality (2.70% vs 3.03%; P>0.99; OR 0.89 [95% CI 0.05-14.80]). The median duration of hospitalization in case and control groups was 5.08 and 7.52 days (Q1-Q3, 0.06-6.12 vs 0.17-9.83; P=0.03), respectively. Logistic regression analyses did not suggest significant association between the categorical endpoints and the colchicine treatment.
Conclusions: In this retrospective analysis, colchicine therapy failed to show a benefit in the prevention of ARDS in hospitalized COVID19 patients; however, showed a significant reduction in the duration of hospitalization.