Colchicine flops for long COVID treatment

Treatment with colchicine does not appear to improve functional capacity, respiratory function, or inflammatory markers in adults with long COVID, as shown in a study.

The study included 346 adult participants (mean age 46 years, 60.4 percent female) with confirmed SARS-CoV-2 infection and persistent symptoms, had functional limitation (Post–COVID-19 Functional Status scale grade ≥2), and/or elevated inflammatory markers (high-sensitivity C-reactive protein >0.20 mg/dL and/or neutrophil to lymphocyte ratio >5). These participants were randomly assigned to receive colchicine at 0.5 mg once or twice daily, based on body weight, or placebo for 26 weeks.

Distance walked during a 6-min walk test at 52 weeks was evaluated as the primary outcome. Secondary outcomes included changes in inflammatory markers and patient-reported outcome measures, such as quality of life, anxiety, depression, fatigue, dyspnoea. Outcomes were assessed at 12, 26, and 52 weeks after randomization.

At 52 weeks, the mean change in 6-min walk test distance did not significantly differ between the colchicine and placebo groups (35.5 vs 29.96 m; mean difference, 5.59 m, 95 percent confidence interval [CI], –9.00 to 20.18; p=0.45).

Results for other outcomes were also comparable between the two treatment groups, with the exception of a small, nonclinically relevant difference in the mean ratio of forced expiratory volume in 1 second to forced vital capacity (−0.02 with colchicine vs −0.06 with placebo; mean difference, 0.04, 95 percent CI, 0.02–0.07; p=0.001).

The present data provide evidence against the use of colchicine monotherapy for treating adults with long COVID and underscore the need to explore alternative therapeutic approaches.