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Gout drug may help treat inflammation linked to severe COVID-19, study finds

Gout drug may help treat inflammation linked to severe COVID-19, study finds
A drug used for gout, called colchicine, may be effective at reducing inflammation in patients with moderate COVID-19 infections, according to new research. Photo by frolicsomepl/Pixabay

Feb. 4 (UPI) -- A drug used to treat gout reduces the need for supplemental oxygen and speeds recovery in patients hospitalized with severe COVID-19, according to a study published Thursday by RMD Open.

Infected patients treated with the drug, colchicine, needed oxygen support to maintain breathing for nearly three fewer days and spent two fewer days in the hospital than those not given the anti-inflammatory.

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Colchicine, which the authors of the study describe as inexpensive, is used to treat and prevent systemic inflammatory conditions, including gout.

Systemic inflammation is common in people with moderate to severe COVID-19 infection.

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"Colchicine, an old drug widely used for some acute and chronic inflammatory diseases [and] it can be safely used in patients hospitalized due to COVID-19 pneumonia," study co-author Dr. Rene Oliveira told UPI.

"Our hypothesis is that by inhibiting neutrophil activation and reducing the production of some cytokines [in] the cytokine storm, the drug is useful to diminish the hyperactivity of the immune system following ... infection, resulting in less inflammation of the lungs," said Oliveira, an internal medicine researcher at the University of Sao Paulo's Ribeirao Preto Medical School in Brazil.

Although most people with COVID-19 experience mild symptoms, those who suffer serious illness experience often see an overreaction by their the immune systems, causing rapid production of immune proteins called cytokines.

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This so-called "cytokine storm" leads to hyper-inflammation in the lungs and acute respiratory distress syndrome, as well as reduced oxygen levels in the blood, the main cause of death from COVID-19.

The U.S. Food and Drug Administration approved colchicine for use in patients with familial Mediterranean fever, a rare genetic autoimmune disorder, and acute gout flares in 2009.

It's generally safe, but overuse can lead to serious side effects.

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For this study, Oliveira and his colleagues treated 72 patients admitted to their hospital with moderate to severe COVID-19.

Thirty-six of the patients received standard treatment plus 0.5 milligrams of colchicine three times a day for five days followed by the same dose twice a day for five days, and 36 received standard treatment plus a placebo drug.

Only five patients were within a healthy weight range, according to the researchers, which is significant given that being overweight and obese are known risk factors for more severe COVID-19 infection.

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Moderate COVID-19 was defined in the study as fever, breathing difficulties and pneumonia, while severe illness included these symptoms plus a rapid breathing rate of 30 or more times a minute and low levels of oxygen in the body.

Standard treatment consisted of the antibiotic azithromycin, the antimalarial hydroxychloroquine and the blood thinner heparin, plus the steroid methylprednisolone if the need for supplemental oxygen was significant.

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Patients treated with colchicine needed oxygen therapy an average of four days, compared with 6.5 days for those in the standard treatment plus placebo group, the data showed.

The average length of hospital stay was seven days among patients given colchicine group compared to nine days for those who received standard treatment only.

After seven days in treatment, just three patients treated with colchicine needed maintenance oxygen compared with 16 in the standard treatment group.

Two patients died, both of whom were in the placebo group.

It is not entirely clear how colchicine works to fight COVID-19 infection, given that it is not an antiviral drug, the researchers said.

They said it's possible the drug reduces the body's inflammatory response and helps ward off damage to the cells lining the walls of the heart and lungs, among other organs.

"The main event we need to see for the effect of colchicine is the presence of systemic inflammation," Oliveira said.

"With low-grade or no inflammation, as in mild forms of COVID-19, the drug simply can not fulfill its purpose," he said.

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