Investigating the effectiveness of colchicine tablets on the outcomes of mechanically ventilated patients with COVID-19: a randomized clinical trial

Background Inflammatory factors are activated in COVID-19. Colchicine, a drug with anti-inflammatory effects, may reduce lung inflammation in COVID-19. Aim This study investigated the effect of colchicine on the outcomes of mechanically ventilated COVID-19 patients. Methods This randomized, double-blind clinical trial was conducted in an ICU in Iran. 120 COVID-19 patients were assigned to control or intervention groups via block randomization. The control group received routine treatment. The intervention group received oral colchicine (2 mg/day for 5 days; total 10 mg) plus routine care. Demographic data were collected from files. Blood tests were measured on days 1 and 5. Data were analyzed using SPSS 26 with a significance level of < 0.05. Results The mean length of hospital stay was significantly shorter in the intervention group compared to the control (7.8 vs. 15.2 days, p = 0.005). Mortality rate was significantly lower in the intervention group (6.6% vs. 25%, p = 0.006). Post-intervention LDH levels were significantly higher in the intervention group (780.70 vs. 532.86 U/L, p = 0.007). No significant differences were observed in WBC, CRP, and lymphocyte counts. Conclusion A higher-dose regimen of colchicine significantly reduced mortality and hospital stay in mechanically ventilated COVID-19 patients without severe adverse events. The anti-inflammatory effect, potentially through potent NLRP3 inflammasome inhibition, may be dose-dependent. This finding requires caution, and a larger trial is needed to determine the appropriate regimen and timing.