• Eka Noneng Nawangsih, Yudith Yunia Kusmala, Iis Inayati Rakhmat, Dewi Ratih Handayani, Henny Juliastuti, Arief Wibowo, Michael Anthonius Lim, and Raymond Pranata.
• Department of Microbiology, Faculty of Medicine, Universitas Jenderal Achmad Yani, Cimahi, Indonesia. Electronic address: eka.noneng@lecture.unjani.ac.id.
• Int. Immunopharmacol. 2021 Jul 1; 96: 107723.

ObjectiveThis systematic review, with meta-analysis and meta-regression aims to evaluate the effect of colchicine administration on mortality in patients with coronavirus disease 2019 (COVID-19) and factors affecting the association.MethodsA systematic literature search using the PubMed, Scopus, and Embase databases were performed from inception of databases up until 3 March 2021. We included studies that fulfill all of the following criteria: 1) observational studies or randomized controlled trials (RCTs) that report COVID-19 patients, 2) reporting colchicine use, and 3) mortality within 30 days. There was no restriction on the age, inpatients or outpatients setting, and severity of diseases. The intervention was colchicine administration during treatment for COVID-19. The control was receiving placebo or standard of care. The outcome was mortality and the pooled effect estimate was reported as odds ratio (OR). Random-effects restricted maximum likelihood meta-regression was performed to evaluate factors affecting the pooled effect estimate.ResultsEight studies comprising of 5530 patients were included in this systematic review and meta-analysis. There were three RCTs and five observational studies. Pooled analysis showed that colchicine was associated with lower mortality in patients with COVID-19 (OR 0.47 [0.31, 0.72], p = 0.001; I2: 30.9, p = 0.181). Meta-regression analysis showed that the association between colchicine and mortality was reduced by increasing age (OR 0.92 [0.85, 1.00], p = 0.05), but not gender (reference: male, p = 0.999), diabetes (p = 0.376), hypertension (p = 0.133), and CAD (p = 0.354).ConclusionThis meta-analysis indicates that colchicine may reduce mortality in patients with COVID-19. Meta-regression analysis showed that the benefit was reduced as age increases.ProsperoCRD42021240609.Copyright © 2021. Published by Elsevier B.V.

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