Colchicine Ineffective in Long COVID Save

Management of long COVID has been perplexing with symptoms having functional and possibly inflammatory origins. Colchicine has been studied in long COVID and failed to improve functional capacity, respiratory function, or inflammatory markers. 

This double-blind, 1:1 randomized clinical trial recruited participants with confirmed SARS-CoV-2 infection and persistent symptoms between January 2022 and July 2023. To be enrolled individuals had functional limitation (Post–COVID-19 Functional Status scale grade 2 or more) and/or elevated inflammatory markers (high-sensitivity C-reactive protein >0.20 mg/dL and/or neutrophil to lymphocyte ratio >5). Outcomes were assessed at 12, 26, and 52 weeks after randomization.  The primary outcome was the 6-minute walk test from baseline to 52 weeks. 

A total of 346 participants were randomized to receive colchicine, 0.5 mg, once or twice daily, (based on body weight) or placebo for 26 weeks. Patients were 60% female, with a mean age of 46 years. 

Results at 52 weeks:

• Walk time - no difference in mean change in 6-minute walk test distance (colchicine, 35.5m; placebo, 29.96m
• No difference in other predefined outcomes

Among adults with long COVID, colchicine did not improve clinical outcomes. Alternative approaches for long COVID are needed.