The evidence from clinical trials on colchicine and corticosteroids’ effect on COVID-19: a systematic review and meta-analysis

With no clear end for the outbreak, identifying the drugs that are effective in COVID-19’s management is of utmost importance to reduce the impact on the general population and the healthcare systems. This is a systematic review and a meta-analysis evaluating the evidence from clinical trials on the effect of colchicine and corticosteroids against COVID-19. In this review, we have systematically searched five databases [(PubMed, Embase, clinicaltrials.gov, ICTRP, CINAHL (EBSCO)]. Cochrane’s data extraction sheet was used to collect the required information, and RevMan-5.4.1 was used to conduct the meta-analysis and to assess the risk of bias. The review was registered in Prospero (CRD42022299718) The total number of included studies was 17, with 18,956 participants; the majority were male 12,001. Out of which, 8772 participants were on colchicine, 569 took methylprednisolone, and 64 patients received prednisolone. The meta-analysis has shown that colchicine had no significant effect on reducing the mortality rate among COVID-19 patients [OR 0.98(95% CI 0.90–1.08), <i>p</i> = .70), <i>I²</i>:1%)], corticosteroids have significantly reduced the mortality rates [OR 0.55 (95% CI 0.33–0.91), <i>p</i> = .02, <i>I²</i>:40]. Colchicine did not reduce the incidence of ICU admissions [OR 0.74 (95% CI 0.39–1.40), <i>p</i> = .35, <i>I²</i>:0%], while steroidal drugs significantly reduced the ICU admissions [OR 0.42 (95% CI 0.23–0.78), <i>p</i> = .005, <i>I²</i>:0%]. Unlike steroidal drugs [OR 0.53 (95% CI 0.30–0.95), <i>p</i> = .03, <i>I²</i>:61%], colchicine failed to reduce the need for mechanical ventilation [OR 0.73 (95% CI 0.48–1.10), <i>p</i> = .13, <i>I²</i>:76%]. Steroidal drugs significantly reduced the duration of hospitalization among COVID-19 patients [OR −0.50 (95% CI −0.79–0.21), <i>p</i> = .0007, <i>I²</i>:36%]. The use of colchicine did not significantly reduce the mortality rate, ICU admissions, and mechanical ventilation among COVID-19 patients. Conversely, corticosteroids significantly reduced the mortality rate, ICU admissions, mechanical ventilation, and hospitalization duration among COVID-19 patients.