Internal Medicine, New York University Grossman School of Medicine, New York, New York, USA.
Colton Center for Autoimmunity, Department of Medicine and Pathology, New York University School of Medicine, New York, New York, USA.
Ann Rheum Dis. 2021 May;80(5):550-557. doi: 10.1136/annrheumdis-2020-219174. Epub 2020 Dec 8.
The search for effective COVID-19 management strategies continues to evolve. Current understanding of SARS-CoV-2 mechanisms suggests a central role for exaggerated activation of the innate immune system as an important contributor to COVID-19 adverse outcomes. The actions of colchicine, one of the oldest anti-inflammatory therapeutics, target multiple mechanisms associated with COVID-19 excessive inflammation. While many COVID-19 trials have sought to manipulate SARS-CoV-2 or dampen the inflammatory response once patients are hospitalised, few examine therapeutics to prevent the need for hospitalisation. Colchicine is easily administered, generally well tolerated and inexpensive, and holds particular promise to reduce the risk of hospitalisation and mortality due to COVID-19 in the outpatient setting. Successful outpatient treatment of COVID-19 could greatly reduce morbidity, mortality and the demand for rare or expensive care resources (front-line healthcare workers, hospital beds, ventilators, biological therapies), to the benefit of both resource-replete and resource-poor regions.
寻找有效的 COVID-19 管理策略仍在不断发展。目前对 SARS-CoV-2 机制的理解表明,先天免疫系统的过度激活是 COVID-19 不良结局的一个重要因素。秋水仙碱是最古老的抗炎治疗药物之一,其作用针对与 COVID-19 过度炎症相关的多种机制。虽然许多 COVID-19 试验都试图操纵 SARS-CoV-2 或抑制住院患者的炎症反应,但很少有试验研究预防住院的治疗方法。秋水仙碱易于给药,通常耐受性良好且价格低廉,特别有希望降低 COVID-19 门诊患者住院和死亡的风险。COVID-19 的门诊成功治疗可能会大大降低发病率、死亡率和对稀有或昂贵的医疗资源(一线医护人员、病床、呼吸机、生物疗法)的需求,这对资源充足和资源匮乏的地区都有益。