Anti-inflammatory therapy for COVID-19 infection: the case for colchicine
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orcid.org Z Reyes1, Kelly A Hu1, Jacob Teperman1, Theresa L Wampler Muskardin2,3, Jean-Claude Tardif4, Binita Shah5,6, Michael H Pillinger3,7
Author affiliations
Internal Medicine, New York University Grossman School of Medicine, New York, New York, USA
Colton Center for Autoimmunity, Department of Medicine and Pathology, New York University School of Medicine, New York, New York, USA
Rheumatology/Medicine, New York University Grossman School of Medicine, New York, New York, USA
Montreal Heart Institute, Montreal, Québec, Canada
Cardiology/Medicine, New York University Grossman School of Medicine, New York, New York, USA
Cardiology/Medicine, VA New York Harbor Healthcare System, New York, New York, USA
Rheumatology/Medicine, VA New York Harbor Healthcare System, New York, New York, USA
Correspondence to Dr Michael H Pillinger, Rheumatology, New York University School of Medicine, New York, NY 10016, USA; Michael.Pillinger@nyulangone.org
Abstract
The search for effective COVID-19 management strategies continues to evolve. Current understanding of SARS-CoV-2 mechanisms suggests a central role for exaggerated activation of the innate immune system as an important contributor to COVID-19 adverse outcomes. The actions of colchicine, one of the oldest anti-inflammatory therapeutics, target multiple mechanisms associated with COVID-19 excessive inflammation. While many COVID-19 trials have sought to manipulate SARS-CoV-2 or dampen the inflammatory response once patients are hospitalised, few examine therapeutics to prevent the need for hospitalisation. Colchicine is easily administered, generally well tolerated and inexpensive, and holds particular promise to reduce the risk of hospitalisation and mortality due to COVID-19 in the outpatient setting. Successful outpatient treatment of COVID-19 could greatly reduce morbidity, mortality and the demand for rare or expensive care resources (front-line healthcare workers, hospital beds, ventilators, biological therapies), to the benefit of both resource-replete and resource-poor regions.
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