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Colchicine for COVID-19: real-time meta analysis of 32 studies
Covid Analysis, May 27, 2022, DRAFT
https://c19colchicine.com/meta.html
0 0.5 1 1.5+ All studies 38% 32 22,499 Improvement, Studies, Patients Relative Risk Mortality 40% 27 20,771 Ventilation 42% 5 12,575 ICU admission 30% 4 576 Hospitalization 23% 10 6,815 Progression 81% 3 289 Recovery 30% 9 12,419 Cases -73% 1 1,278 RCTs 22% 16 18,820 RCT mortality 9% 13 18,438 Peer-reviewed 41% 29 21,978 Prophylaxis 26% 3 1,278 Late 39% 29 21,221 Colchicine for COVID-19 c19colchicine.com May 2022 Favorscolchicine Favorscontrol after exclusions
Statistically significant improvements are seen for mortality, ICU admission, hospitalization, and recovery. 20 studies from 20 independent teams in 13 different countries show statistically significant improvements in isolation (11 for the most serious outcome).
Meta analysis using the most serious outcome reported shows 38% [27‑48%] improvement. Results are slightly worse for Randomized Controlled Trials, similar after exclusions, and similar for peer-reviewed studies.
Results are robust — in exclusion sensitivity analysis 22 of 32 studies must be excluded to avoid finding statistically significant efficacy in pooled analysis.
0 0.5 1 1.5+ All studies 38% 32 22,499 Improvement, Studies, Patients Relative Risk Mortality 40% 27 20,771 Ventilation 42% 5 12,575 ICU admission 30% 4 576 Hospitalization 23% 10 6,815 Progression 81% 3 289 Recovery 30% 9 12,419 Cases -73% 1 1,278 RCTs 22% 16 18,820 RCT mortality 9% 13 18,438 Peer-reviewed 41% 29 21,978 Prophylaxis 26% 3 1,278 Late 39% 29 21,221 Colchicine for COVID-19 c19colchicine.com May 2022 Favorscolchicine Favorscontrol after exclusions
RCT results are less favorable, however they are dominated by the very late stage RECOVERY RCT, for which the results are not generalizable to earlier usage.
While many treatments have some level of efficacy, they do not replace vaccines and other measures to avoid infection. Only 16% of colchicine studies show zero events in the treatment arm. Multiple treatments are typically used in combination, and other treatments may be more effective. There has been no early treatment studies to date.
No treatment, vaccine, or intervention is 100% available and effective for all variants. All practical, effective, and safe means should be used. Denying the efficacy of treatments increases mortality, morbidity, collateral damage, and endemic risk.
All data to reproduce this paper and sources are in the appendix. Other meta analyses for colchicine can be found in [Yasmin, Zein], showing significant improvements for mortality and severity.
Highlights
Colchicine reduces risk for COVID-19 with very high confidence for mortality, hospitalization, recovery, and in pooled analysis, high confidence for ICU admission, and low confidence for ventilation and progression, however increased risk is seen with low confidence for cases.
We show traditional outcome specific analyses and combined evidence from all studies, incorporating treatment delay, a primary confounding factor in COVID-19 studies.
Real-time updates and corrections, transparent analysis with all results in the same format, consistent protocol for 42 treatments.
A
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Deftereos (RCT) 77% 0.23 [0.03-1.97] death 1/55 4/50 Improvement, RR [CI] Treatment Control Lopes (DB RCT) 80% 0.20 [0.01-4.03] death 0/36 2/36 Brunetti (PSM) 73% 0.27 [0.08-0.89] death 3/33 11/33 Scarsi 85% 0.15 [0.06-0.37] death 122 (n) 140 (n) Salehzadeh (RCT) 23% 0.77 [0.66-0.90] hosp. time 50 (n) 50 (n) Pinzón 35% 0.65 [0.34-1.21] death 14/145 23/156 Sandhu 42% 0.58 [0.40-0.85] death 16/34 63/78 Rodriguez-Nava 6% 0.94 [0.61-1.47] death 16/52 85/261 Mahale -7% 1.07 [0.59-1.96] death 11/39 25/95 Valerio Pas.. (ICU) 23% 0.77 [0.31-1.94] death 5/35 12/30 ICU patients CT​1 Tardif (DB RCT) 44% 0.56 [0.19-1.67] death 5/2,235 9/2,253 Mareev 80% 0.20 [0.01-4.01] death 0/21 2/22 García-Posada 57% 0.43 [0.16-0.84] death 48/99 59/110 CT​1 Manenti (PSW) 76% 0.24 [0.09-0.67] death 71 (n) 70 (n) Mostafaie (RCT) 83% 0.17 [0.02-1.34] death 1/60 6/60 CT​1 Recovery C.. (RCT) -1% 1.01 [0.93-1.10] death 1,173/5,610 1,190/5,730 Hueda-Zavaleta 54% 0.46 [0.23-0.91] death 10/50 109/301 Kevorkian 96% 0.04 [0.01-0.21] progression 28 (n) 40 (n) CT​1 Gaitán-Dua.. (RCT) 22% 0.78 [0.44-1.36] death 22/153 28/161 CT​1 Pascual-Fi.. (RCT) 80% 0.20 [0.01-4.03] death 0/52 2/51 Dorward (RCT) 70% 0.30 [0.01-7.37] death 0/156 1/120 Absalón-.. (DB RCT) 29% 0.71 [0.21-2.40] death 4/56 6/60 Diaz (RCT) 12% 0.88 [0.70-1.12] death 131/640 142/639 Alsultan (RCT) 36% 0.64 [0.20-2.07] death 3/14 7/21 Karakaş 13% 0.87 [0.46-1.64] death 16/165 19/171 Pourdowlat (RCT) 73% 0.27 [0.11-0.71] hosp. 5/102 18/100 Gorial (RCT) 67% 0.33 [0.04-3.14] death 1/80 3/80 Pimenta B.. (RCT) 79% 0.21 [0.01-4.05] death 0/14 2/16 Jalal (RCT) 24% 0.76 [0.62-0.93] hosp. time 36 (n) 44 (n) Tau​2 = 0.10, I​2 = 74.4%, p < 0.0001 Late treatment 39% 0.61 [0.50-0.73] 1,485/10,243 1,828/10,978 39% improvement Monserrat V.. (PSM) 80% 0.20 [0.02-0.93] death n/a n/a Improvement, RR [CI] Treatment Control Topless 23% 0.77 [0.56-1.07] death Oztas -406% 5.06 [0.59-43.2] hosp. 5/635 1/643 Tau​2 = 0.86, I​2 = 69.7%, p = 0.66 Prophylaxis 26% 0.74 [0.21-2.66] 5/635 1/643 26% improvement All studies 38% 0.62 [0.52-0.73] 1,490/10,878 1,829/11,621 38% improvement 32 colchicine COVID-19 studies c19colchicine.com May 2022 Tau​2 = 0.10, I​2 = 73.4%, p < 0.0001 Effect extraction pre-specified(most serious outcome, see appendix) 1 CT: study uses combined treatment Favors colchicine Favors control
Figure 1. A. Random effects meta-analysis. This plot shows pooled effects, discussion can be found in the heterogeneity section, and results for specific outcomes can be found in the individual outcome analyses. Effect extraction is pre-specified, using the most serious outcome reported. For details of effect extraction see the appendix. B. Scatter plot showing the distribution of effects reported in studies. C. History of all reported effects (chronological within treatment stages).
Introduction
We analyze all significant studies concerning the use of colchicine for COVID-19. Search methods, inclusion criteria, effect extraction criteria (more serious outcomes have priority), all individual study data, PRISMA answers, and statistical methods are detailed in Appendix 1. We present random effects meta-analysis results for all studies, for studies within each treatment stage, for individual outcomes, for peer-reviewed studies, for Randomized Controlled Trials (RCTs), and after exclusions.
Figure 2 shows stages of possible treatment for COVID-19. Prophylaxis refers to regularly taking medication before becoming sick, in order to prevent or minimize infection. Early Treatment refers to treatment immediately or soon after symptoms appear, while Late Treatment refers to more delayed treatment.
Figure 2. Treatment stages.
Results
Figure 3 shows a visual overview of the results, with details in Table 1 and Table 2. Figure 4, 5, 6, 7, 8, 9, 10, 11, and 12 show forest plots for a random effects meta-analysis of all studies with pooled effects, mortality results, ventilation, ICU admission, hospitalization, progression, recovery, cases, and peer reviewed studies.
0 0.5 1 1.5+ ALL STUDIES MORTALITY VENTILATION ICU ADMISSION HOSPITALIZATION PROGRESSION RECOVERY CASES RCTS RCT MORTALITY PEER-REVIEWED After Exclusions ALL STUDIES All Prophylaxis Late Colchicine for COVID-19 C19COLCHICINE.COM MAY 2022
Figure 3. Overview of results.
Treatment timeNumber of studies reporting positive effects Total number of studiesPercentage of studies reporting positive effects Random effects meta-analysis results
Late treatment 27 29 93.1% 39% improvement
RR 0.61 [0.50‑0.73]
p < 0.0001
Prophylaxis 2 3 66.7% 26% improvement
RR 0.74 [0.21‑2.66]
p = 0.66
All studies 29 32 90.6% 38% improvement
RR 0.62 [0.52‑0.73]
p < 0.0001
Table 1. Results by treatment stage.
Studies Late treatment Prophylaxis PatientsAuthors
All studies 3239% [27‑50%]26% [-166‑79%] 22,499 612
With exclusions 2651% [37‑62%]53% [-67‑87%] 19,079 452
Peer-reviewed 2942% [28‑53%]26% [-166‑79%] 21,978 599
Randomized Controlled TrialsRCTs 1622% [8‑34%] 18,820 395
Table 2. Results by treatment stage for all studies and with different exclusions.
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Deftereos (RCT) 77% 0.23 [0.03-1.97] death 1/55 4/50 Improvement, RR [CI] Treatment Control Lopes (DB RCT) 80% 0.20 [0.01-4.03] death 0/36 2/36 Brunetti (PSM) 73% 0.27 [0.08-0.89] death 3/33 11/33 Scarsi 85% 0.15 [0.06-0.37] death 122 (n) 140 (n) Salehzadeh (RCT) 23% 0.77 [0.66-0.90] hosp. time 50 (n) 50 (n) Pinzón 35% 0.65 [0.34-1.21] death 14/145 23/156 Sandhu 42% 0.58 [0.40-0.85] death 16/34 63/78 Rodriguez-Nava 6% 0.94 [0.61-1.47] death 16/52 85/261 Mahale -7% 1.07 [0.59-1.96] death 11/39 25/95 Valerio Pas.. (ICU) 23% 0.77 [0.31-1.94] death 5/35 12/30 ICU patients CT​1 Tardif (DB RCT) 44% 0.56 [0.19-1.67] death 5/2,235 9/2,253 Mareev 80% 0.20 [0.01-4.01] death 0/21 2/22 García-Posada 57% 0.43 [0.16-0.84] death 48/99 59/110 CT​1 Manenti (PSW) 76% 0.24 [0.09-0.67] death 71 (n) 70 (n) Mostafaie (RCT) 83% 0.17 [0.02-1.34] death 1/60 6/60 CT​1 Recovery C.. (RCT) -1% 1.01 [0.93-1.10] death 1,173/5,610 1,190/5,730 Hueda-Zavaleta 54% 0.46 [0.23-0.91] death 10/50 109/301 Kevorkian 96% 0.04 [0.01-0.21] progression 28 (n) 40 (n) CT​1 Gaitán-Dua.. (RCT) 22% 0.78 [0.44-1.36] death 22/153 28/161 CT​1 Pascual-Fi.. (RCT) 80% 0.20 [0.01-4.03] death 0/52 2/51 Dorward (RCT) 70% 0.30 [0.01-7.37] death 0/156 1/120 Absalón-.. (DB RCT) 29% 0.71 [0.21-2.40] death 4/56 6/60 Diaz (RCT) 12% 0.88 [0.70-1.12] death 131/640 142/639 Alsultan (RCT) 36% 0.64 [0.20-2.07] death 3/14 7/21 Karakaş 13% 0.87 [0.46-1.64] death 16/165 19/171 Pourdowlat (RCT) 73% 0.27 [0.11-0.71] hosp. 5/102 18/100 Gorial (RCT) 67% 0.33 [0.04-3.14] death 1/80 3/80 Pimenta B.. (RCT) 79% 0.21 [0.01-4.05] death 0/14 2/16 Jalal (RCT) 24% 0.76 [0.62-0.93] hosp. time 36 (n) 44 (n) Tau​2 = 0.10, I​2 = 74.4%, p < 0.0001 Late treatment 39% 0.61 [0.50-0.73] 1,485/10,243 1,828/10,978 39% improvement Monserrat V.. (PSM) 80% 0.20 [0.02-0.93] death n/a n/a Improvement, RR [CI] Treatment Control Topless 23% 0.77 [0.56-1.07] death Oztas -406% 5.06 [0.59-43.2] hosp. 5/635 1/643 Tau​2 = 0.86, I​2 = 69.7%, p = 0.66 Prophylaxis 26% 0.74 [0.21-2.66] 5/635 1/643 26% improvement All studies 38% 0.62 [0.52-0.73] 1,490/10,878 1,829/11,621 38% improvement 32 colchicine COVID-19 studies c19colchicine.com May 2022 Tau​2 = 0.10, I​2 = 73.4%, p < 0.0001 Effect extraction pre-specified(most serious outcome, see appendix) 1 CT: study uses combined treatment Favors colchicine Favors control
Figure 4. Random effects meta-analysis for all studies with pooled effects. This plot shows pooled effects, discussion can be found in the heterogeneity section, and results for specific outcomes can be found in the individual outcome analyses. Effect extraction is pre-specified, using the most serious outcome reported. For details of effect extraction see the appendix.
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Deftereos (RCT) 77% 0.23 [0.03-1.97] 1/55 4/50 Improvement, RR [CI] Treatment Control Lopes (DB RCT) 80% 0.20 [0.01-4.03] 0/36 2/36 Brunetti (PSM) 73% 0.27 [0.08-0.89] 3/33 11/33 Scarsi 85% 0.15 [0.06-0.37] 122 (n) 140 (n) Pinzón 35% 0.65 [0.34-1.21] 14/145 23/156 Sandhu 42% 0.58 [0.40-0.85] 16/34 63/78 Rodriguez-Nava 6% 0.94 [0.61-1.47] 16/52 85/261 Mahale -7% 1.07 [0.59-1.96] 11/39 25/95 Valerio Pas.. (ICU) 23% 0.77 [0.31-1.94] 5/35 12/30 ICU patients CT​1 Tardif (DB RCT) 44% 0.56 [0.19-1.67] 5/2,235 9/2,253 Mareev 80% 0.20 [0.01-4.01] 0/21 2/22 García-Posada 57% 0.43 [0.16-0.84] 48/99 59/110 CT​1 Manenti (PSW) 76% 0.24 [0.09-0.67] 71 (n) 70 (n) Mostafaie (RCT) 83% 0.17 [0.02-1.34] 1/60 6/60 CT​1 Recovery C.. (RCT) -1% 1.01 [0.93-1.10] 1,173/5,610 1,190/5,730 Hueda-Zavaleta 54% 0.46 [0.23-0.91] 10/50 109/301 Gaitán-Dua.. (RCT) 22% 0.78 [0.44-1.36] 22/153 28/161 CT​1 Pascual-Fi.. (RCT) 80% 0.20 [0.01-4.03] 0/52 2/51 Dorward (RCT) 70% 0.30 [0.01-7.37] 0/156 1/120 Absalón-.. (DB RCT) 29% 0.71 [0.21-2.40] 4/56 6/60 Diaz (RCT) 12% 0.88 [0.70-1.12] 131/640 142/639 Alsultan (RCT) 36% 0.64 [0.20-2.07] 3/14 7/21 Karakaş 13% 0.87 [0.46-1.64] 16/165 19/171 Gorial (RCT) 67% 0.33 [0.04-3.14] 1/80 3/80 Pimenta B.. (RCT) 79% 0.21 [0.01-4.05] 0/14 2/16 Tau​2 = 0.14, I​2 = 72.6%, p < 0.0001 Late treatment 40% 0.60 [0.48-0.75] 1,480/10,027 1,810/10,744 40% improvement Monserrat V.. (PSM) 80% 0.20 [0.02-0.93] n/a n/a Improvement, RR [CI] Treatment Control Topless 23% 0.77 [0.56-1.07] Tau​2 = 0.64, I​2 = 71.1%, p = 0.24 Prophylaxis 53% 0.47 [0.13-1.67] 53% improvement All studies 40% 0.60 [0.49-0.74] 1,480/10,027 1,810/10,744 40% improvement 27 colchicine COVID-19 mortality results c19colchicine.com May 2022 Tau​2 = 0.13, I​2 = 72.0%, p < 0.0001 1 CT: study uses combined treatment Favors colchicine Favors control
Figure 5. Random effects meta-analysis for mortality results.
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Deftereos (RCT) 82% 0.18 [0.02-1.50] 1/55 5/50 Improvement, RR [CI] Treatment Control Sandhu 53% 0.47 [0.33-0.67] 16/34 68/68 Tardif (DB RCT) 47% 0.53 [0.25-1.09] 11/2,235 21/2,253 Recovery C.. (RCT) -18% 1.18 [0.99-1.40] 259/3,815 228/3,962 Pascual-Fi.. (RCT) 80% 0.20 [0.01-4.03] 0/52 2/51 Tau​2 = 0.36, I​2 = 85.3%, p = 0.12 Late treatment 42% 0.58 [0.30-1.16] 287/6,191 324/6,384 42% improvement All studies 42% 0.58 [0.30-1.16] 287/6,191 324/6,384 42% improvement 5 colchicine COVID-19 mechanical ventilation results c19colchicine.com May 2022 Tau​2 = 0.36, I​2 = 85.3%, p = 0.12 Favors colchicine Favors control
Figure 6. Random effects meta-analysis for ventilation.
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Lopes (DB RCT) 50% 0.50 [0.10-2.56] 2/36 4/36 Improvement, RR [CI] Treatment Control Valerio Pas.. (ICU) 40% 0.60 [0.38-0.95] 35 (n) 30 (n) ICU patients CT​1 Pascual-Fi.. (RCT) 51% 0.49 [0.09-2.56] 2/52 4/51 Karakaş 16% 0.84 [0.55-1.29] 30/165 37/171 Tau​2 = 0.00, I​2 = 0.0%, p = 0.021 Late treatment 30% 0.70 [0.52-0.95] 34/288 45/288 30% improvement All studies 30% 0.70 [0.52-0.95] 34/288 45/288 30% improvement 4 colchicine COVID-19 ICU results c19colchicine.com May 2022 Tau​2 = 0.00, I​2 = 0.0%, p = 0.021 1 CT: study uses combined treatment Favors colchicine Favors control
Figure 7. Random effects meta-analysis for ICU admission.
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Lopes (DB RCT) 22% 0.78 [0.64-0.94] hosp. time 36 (n) 36 (n) Improvement, RR [CI] Treatment Control Salehzadeh (RCT) 23% 0.77 [0.66-0.90] hosp. time 50 (n) 50 (n) Tardif (DB RCT) 20% 0.80 [0.61-1.03] hosp. 101/2,235 128/2,253 Mareev 26% 0.74 [0.53-1.04] hosp. time 21 (n) 22 (n) Mostafaie (RCT) 35% 0.65 [0.53-0.81] hosp. time 59 (n) 54 (n) CT​1 Pascual-Fi.. (RCT) -15% 1.15 [0.87-1.51] hosp. time 52 (n) 51 (n) Karakaş 25% 0.75 [0.65-0.87] hosp. time 165 (n) 171 (n) Pourdowlat (RCT) 73% 0.27 [0.11-0.71] hosp. 5/102 18/100 Jalal (RCT) 24% 0.76 [0.62-0.93] hosp. time 36 (n) 44 (n) Tau​2 = 0.01, I​2 = 47.1%, p < 0.0001 Late treatment 23% 0.77 [0.69-0.85] 106/2,756 146/2,781 23% improvement Oztas -406% 5.06 [0.59-43.2] hosp. 5/635 1/643 Improvement, RR [CI] Treatment Control Tau​2 = 0.00, I​2 = 0.0%, p = 0.14 Prophylaxis -406% 5.06 [0.59-43.2] 5/635 1/643 -406% improvement All studies 23% 0.77 [0.69-0.86] 111/3,391 147/3,424 23% improvement 10 colchicine COVID-19 hospitalization results c19colchicine.com May 2022 Tau​2 = 0.01, I​2 = 50.2%, p < 0.0001 1 CT: study uses combined treatment Favors colchicine Favors control
Figure 8. Random effects meta-analysis for hospitalization.
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Deftereos (RCT) 87% 0.13 [0.01-0.97] 1/55 7/50 Improvement, RR [CI] Treatment Control Kevorkian 96% 0.04 [0.01-0.21] 28 (n) 40 (n) CT​1 Absalón-.. (DB RCT) 17% 0.83 [0.35-1.93] 56 (n) 60 (n) Tau​2 = 2.47, I​2 = 80.7%, p = 0.1 Late treatment 81% 0.19 [0.03-1.38] 1/139 7/150 81% improvement All studies 81% 0.19 [0.03-1.38] 1/139 7/150 81% improvement 3 colchicine COVID-19 progression results c19colchicine.com May 2022 Tau​2 = 2.47, I​2 = 80.7%, p = 0.1 1 CT: study uses combined treatment Favors colchicine Favors control
Figure 9. Random effects meta-analysis for progression.
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Brunetti (PSM) 73% 0.27 [0.08-0.89] no disch. 3/33 11/33 Improvement, RR [CI] Treatment Control Sandhu 42% 0.58 [0.40-0.85] no disch. 16/34 63/78 Mareev 50% 0.50 [0.24-1.04] no recov. 21 (n) 22 (n) Manenti (PSW) 44% 0.56 [0.31-1.00] no recov. 71 (n) 70 (n) Recovery C.. (RCT) -2% 1.02 [0.97-1.06] no disch. 1,709/5,610 1,698/5,730 Dorward (RCT) -6% 1.06 [0.81-1.39] no recov. 156 (n) 133 (n) Absalón-.. (DB RCT) -13% 1.13 [0.76-1.66] no recov. 56 (n) 60 (n) Pourdowlat (RCT) 38% 0.62 [0.41-0.94] no recov. 89 (n) 63 (n) Gorial (RCT) 63% 0.37 [0.21-0.67] no recov. 80 (n) 80 (n) Tau​2 = 0.10, I​2 = 78.1%, p = 0.0085 Late treatment 30% 0.70 [0.54-0.91] 1,728/6,150 1,772/6,269 30% improvement All studies 30% 0.70 [0.54-0.91] 1,728/6,150 1,772/6,269 30% improvement 9 colchicine COVID-19 recovery results c19colchicine.com May 2022 Tau​2 = 0.10, I​2 = 78.1%, p = 0.0085 Favors colchicine Favors control
Figure 10. Random effects meta-analysis for recovery.
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Oztas -73% 1.73 [0.96-3.11] symp. case 29/635 17/643 Improvement, RR [CI] Treatment Control Tau​2 = 0.00, I​2 = 0.0%, p = 0.068 Prophylaxis -73% 1.73 [0.96-3.11] 29/635 17/643 -73% improvement All studies -73% 1.73 [0.96-3.11] 29/635 17/643 -73% improvement 1 colchicine COVID-19 case result c19colchicine.com May 2022 Tau​2 = 0.00, I​2 = 0.0%, p = 0.068 Favors colchicine Favors control
Figure 11. Random effects meta-analysis for cases.
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Deftereos (RCT) 77% 0.23 [0.03-1.97] death 1/55 4/50 Improvement, RR [CI] Treatment Control Lopes (DB RCT) 80% 0.20 [0.01-4.03] death 0/36 2/36 Brunetti (PSM) 73% 0.27 [0.08-0.89] death 3/33 11/33 Scarsi 85% 0.15 [0.06-0.37] death 122 (n) 140 (n) Sandhu 42% 0.58 [0.40-0.85] death 16/34 63/78 Rodriguez-Nava 6% 0.94 [0.61-1.47] death 16/52 85/261 Mahale -7% 1.07 [0.59-1.96] death 11/39 25/95 Valerio Pas.. (ICU) 23% 0.77 [0.31-1.94] death 5/35 12/30 ICU patients CT​1 Tardif (DB RCT) 44% 0.56 [0.19-1.67] death 5/2,235 9/2,253 Mareev 80% 0.20 [0.01-4.01] death 0/21 2/22 García-Posada 57% 0.43 [0.16-0.84] death 48/99 59/110 CT​1 Manenti (PSW) 76% 0.24 [0.09-0.67] death 71 (n) 70 (n) Recovery C.. (RCT) -1% 1.01 [0.93-1.10] death 1,173/5,610 1,190/5,730 Hueda-Zavaleta 54% 0.46 [0.23-0.91] death 10/50 109/301 Kevorkian 96% 0.04 [0.01-0.21] progression 28 (n) 40 (n) CT​1 Gaitán-Dua.. (RCT) 22% 0.78 [0.44-1.36] death 22/153 28/161 CT​1 Pascual-Fi.. (RCT) 80% 0.20 [0.01-4.03] death 0/52 2/51 Dorward (RCT) 70% 0.30 [0.01-7.37] death 0/156 1/120 Absalón-.. (DB RCT) 29% 0.71 [0.21-2.40] death 4/56 6/60 Diaz (RCT) 12% 0.88 [0.70-1.12] death 131/640 142/639 Alsultan (RCT) 36% 0.64 [0.20-2.07] death 3/14 7/21 Karakaş 13% 0.87 [0.46-1.64] death 16/165 19/171 Pourdowlat (RCT) 73% 0.27 [0.11-0.71] hosp. 5/102 18/100 Gorial (RCT) 67% 0.33 [0.04-3.14] death 1/80 3/80 Pimenta B.. (RCT) 79% 0.21 [0.01-4.05] death 0/14 2/16 Jalal (RCT) 24% 0.76 [0.62-0.93] hosp. time 36 (n) 44 (n) Tau​2 = 0.14, I​2 = 75.9%, p < 0.0001 Late treatment 42% 0.58 [0.47-0.72] 1,470/9,988 1,799/10,712 42% improvement Monserrat V.. (PSM) 80% 0.20 [0.02-0.93] death n/a n/a Improvement, RR [CI] Treatment Control Topless 23% 0.77 [0.56-1.07] death Oztas -406% 5.06 [0.59-43.2] hosp. 5/635 1/643 Tau​2 = 0.86, I​2 = 69.7%, p = 0.66 Prophylaxis 26% 0.74 [0.21-2.66] 5/635 1/643 26% improvement All studies 41% 0.59 [0.48-0.73] 1,475/10,623 1,800/11,355 41% improvement 29 colchicine COVID-19 peer reviewed trials c19colchicine.com May 2022 Tau​2 = 0.13, I​2 = 74.8%, p < 0.0001 Effect extraction pre-specified(most serious outcome, see appendix) 1 CT: study uses combined treatment