Colchicine in COVID-19: Mechanistic Insights and Clinical Uncertainties

Coronavirus Disease 2019 (COVID-19) which caused by the novel coronavirus SARS-CoV-2 has been emerged as a global health crisis characterised by severe immune dysregulation and inflammatory complications. The hyper-activation of the immune response in COVID-19 patients is associated with disease progression and severity. As a result, immunomodulatory therapies such as colchicine have been suggested to control exaggerated immune response in COVID-19. However, the therapeutic role of colchicine in COVID-19 remains a subject of debate due to conflicting evidence. This review highlights both the beneficial and potentially harmful effects of colchicine in the context of COVID-19. Notably, the therapeutic advantages of colchicine are linked to the suppression of immune cell over-activation, attenuation of oxidative stress, and prevention of thrombo-inflammatory events. Conversely, colchicine may exert negative effects by disrupting microtubule function, impairing autophagic processes, and inducing mitochondrial dysfunction in COVID-19. In conclusion, the overall clinical impact of colchicine plays a critical role in the management of COVID-19. However, its dual effects underscore the need for well-designed clinical studies to confirm its safety and efficacy in COVID-19 management.