Assessing the Impact of Colchicine on Pulmonary Fibrosis Using Imaging in Patients With Moderate‐to‐Severe COVID‐19 Pneumonia

TL;DR

This study shows that colchicine may help reduce lung scarring in patients with severe COVID-19 pneumonia over 15 months.

Contribution

The study provides new evidence that colchicine could slow or prevent post-COVID pulmonary fibrosis.

Findings

Patients receiving colchicine showed significant regression in chest CT abnormalities compared to the control group.

65.6% of the colchicine group experienced symptomatic improvement, significantly higher than 35.4% in the control group.

Colchicine treatment was associated with less progression of pulmonary fibrosis stages over 15 months.

Abstract

Pulmonary fibrosis may develop in patients with severe clinical conditions, especially those with high inflammatory indicators. We aimed to investigate the 15‐month follow‐up clinical outcomes in patients with moderate‐to‐severe COVID‐19 pneumonia treated with colchicine and to evaluate its potential in preventing post‐COVID pulmonary fibrosis.

This study, beginning with a retrospective analysis of 1489 selected patients, and a follow‐up assessment of 155 patients conducted 15 months after hospital discharge. This study included 90 patients presenting with COVID‐19 pneumonia with severity ranging from moderate to severe who were treated with colchicine alongside standard care, and 65 patients who did not receive colchicine were included in the control group to serve as a comparator. Patients who received colchicine treatment were included in Group 1, and those that did not in Group 2.

From admission to the 15‐month follow‐up, patients receiving colchicine exhibited a significant regression in chest CT abnormalities when compared with the control group (p < 0.05). Additionally, 65.6% (n = 59) of the colchicine group experienced symptomatic improvement, significantly higher than 35.4% (n = 23) in the control group (p < 0.05). Ninety patients who received colchicine treatment had Stage 3, 4, or 5, and only 28 had Stage 3, 4, or 5 pulmonary fıbrosis at the end of 15 months. After 15 months of follow‐up, all 20 patients initially classified as Stage 5 who received colchicine remained at Stage 5 pulmonary fibrosis, whereas in the control group, 2 patients (3.1%) were fibrosis‐free, and the others presented with Stage 1 (n = 23; 35.4%), Stage 3 (n = 23; 35.4%), Stage 4 (n = 9; 13.8%), or Stage 5 (n = 8; 12.3%) pulmonary fibrosis.

This study demonstrates that colchicine therapy might reduce pulmonary fibrosis progression in individuals affected by COVID‐19 pneumonia. Clinicians should consider colchicine treatment to prevent pulmonary fibrosis.

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