• Mirko Scarsi, Silvia Piantoni, Enrico Colombo, Paolo Airó, Donata Richini, Marco Miclini, Valeria Bertasi, Marta Bianchi, Damiano Bottone, Patrizia Civelli, Maria-Sofia Cotelli, Ezio Damiolini, Gloria Galbassini, Diego Gatta, Maria-Laura Ghirardelli, Roberto Magri, Paola Malamani, Monia Mendeni, Stefano Molinari, Andrea Morotti, Luisa Salada, Marinella Turla, Angiola Vender, Angela Tincani, Antonio Brucato, Franco Franceschini, Roberto Furloni, and Laura Andreoli.
• Internal Medicine Department - Hospital of Esine, ASST della Valcamonica, Esine, Lombardia, Italy m.scarsi@asst-valcamonica.it.
• Ann. Rheum. Dis. 2020 Oct 1; 79 (10): 1286-1289.

ObjectivesThe outbreak of COVID-19 posed the issue of urgently identifying treatment strategies. Colchicine was considered for this purpose based on well-recognised anti-inflammatory effects and potential antiviral properties. In the present study, colchicine was proposed to patients with COVID-19, and its effects compared with 'standard-of-care' (SoC).MethodsIn the public hospital of Esine, northern Italy, 140 consecutive inpatients, with virologically and radiographically confirmed COVID-19 admitted in the period 5-19 March 2020, were treated with 'SoC' (hydroxychloroquine and/or intravenous dexamethasone; and/or lopinavir/ritonavir). They were compared with 122 consecutive inpatients, admitted between 19 March and 5 April 2020, treated with colchicine (1 mg/day) and SoC (antiviral drugs were stopped before colchicine, due to potential interaction).ResultsPatients treated with colchicine had a better survival rate as compared with SoC at 21 days of follow-up (84.2% (SE=3.3%) vs 63.6% (SE=4.1%), p=0.001). Cox proportional hazards regression survival analysis showed that a lower risk of death was independently associated with colchicine treatment (HR=0.151 (95% CI 0.062 to 0.368), p<0.0001), whereas older age, worse PaO2/FiO2, and higher serum levels of ferritin at entry were associated with a higher risk.ConclusionThis proof-of-concept study may support the rationale of use of colchicine for the treatment of COVID-19. Efficacy and safety must be determined in controlled clinical trials.© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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