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Colchicine for the Treatment of Myocardial Injury in Patients With Coronavirus Disease 2019 (COVID-19)—An Old Drug With New Life?

Educational Objective
To understand how COVID-19 has given Colchicine new life as a form of treatment of myocardial injury
1 Credit CME

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected more than 6 million individuals worldwide, leading to the ongoing coronavirus disease 2019 (COVID-19) pandemic and significant morbidity and mortality. Patients with active myocardial injury (ie, elevated troponin levels) are at a very high risk, with mortality rates reaching as high as 40%.1,2 In particular, the subset of patients with evidence of myocardial injury and underlying cardiovascular disease are at exceedingly high risk, with mortality rates of nearly 70%.1,2 While several mechanisms have been postulated for how SARS-CoV-2 may damage the lungs, heart, and other organs, indirect damage from innate, cellular, and/or humoral immune responses, including a severe cytokine storm, is a leading hypothesis supported by numerous studies reporting significantly elevated inflammatory biomarkers in patients with COVID-19.

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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Published: June 24, 2020. doi:10.1001/jamanetworkopen.2020.13556

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2020 Rabbani AB et al. JAMA Network Open.

Corresponding Author: Amir B. Rabbani, MD, Division of Cardiology, University of California, Los Angeles, 3500 Lomita Blvd, Ste M100, Torrance, CA 90505 (arabbani@mednet.ucla.edu).

Conflict of Interest Disclosures: None reported.

References
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2.
Deng  Y , Liu  W , Liu  K ,  et al.  Clinical characteristics of fatal and recovered cases of coronavirus disease 2019 (COVID-19) in Wuhan, China: a retrospective study.   Chin Med J (Engl). Published March 20, 2020. doi:10.1097/CM9.0000000000000824PubMedGoogle Scholar
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6.
Tardif  JC , Kouz  S , Waters  DD ,  et al.  Efficacy and safety of low-dose colchicine after myocardial infarction.   N Engl J Med. 2019;381(26):2497-2505. doi:10.1056/NEJMoa1912388PubMedGoogle ScholarCrossref
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Deftereos  SG , Giannopoulos  G , Vrachatis  DA ,  et al; GRECCO-19 Investigators.  Effect of colchicine vs standard care on cardiac and inflammatory biomarkers and clinical outcomes in patients hospitalized with coronavirus disease 2019: the GRECCO-19 randomized clinical trial.   JAMA Netw Open. 2020;3(6):e2013136. doi:10.1001/jamanetworkopen.2020.13136Google Scholar
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