A randomized clinical trial finds that the anti-inflammatory drug colchicine, once thought promising for treating COVID-19, is no better than placebo in terms of functional capacity, respiratory function, symptoms such as depression or fatigue, or inflammation in long-COVID patients 1 year after infection.

The double-blind trial, led by researchers at the George Institute for Global Health India in Delhi, randomly assigned 346 adult long-COVID patients to 28 weeks of colchicine therapy (162 patients) or placebo (157) at eight hospitals in six states in India from January 2022 to July 2023.

Participants, who had functional limitations and/or elevated inflammatory markers, were evaluated 12, 26, and 52 weeks after randomization. Of the 346 participants, 60.4% were women, and the average age was 46 years. 

Colchicine is often used to reduce inflammation and pain in patients with gout, a buildup of uric-acid crystals in the joints, and is approved in the United States to treat inflammation in heart disease.

The findings were published this week in JAMA Internal Medicine.

Alternative therapies needed

In total, 35.0% of participants were hospitalized for their infections, 15 were admitted to an intensive care unit, and 4 needed mechanical ventilation. The most common persistent symptoms were muscle pain (72.0%), breathlessness (63.0%), and insomnia (41.0%).

In this randomized clinical trial, among adults with long COVID, colchicine did not improve functional capacity, respiratory function, or inflammatory markers.

At 52 weeks, no difference was noted between colchicine and placebo recipients in average change in 6-minute walk test distance. Similar null results were observed for all studied outcomes, except for a modest, nonclinically relevant difference in pulmonary function.

Treatment effects didn't differ by body weight, hospitalization for COVID-19 infection, sex, or any underlying medical condition. The rate of adverse events (AEs) was similar between the two groups (colchicine, 19.9%; placebo, 17.6%). Most AEs were mild or moderate.

"In this randomized clinical trial, among adults with long COVID, colchicine did not improve functional capacity, respiratory function, or inflammatory markers," the study authors concluded. "These findings underscore the need to explore alternative therapeutic approaches for long COVID."

In the past 2 days the US Department of Agriculture's Animal and Plant Health Inspection Service (APHIS) has reported several new detections of highly pathogenic avian flu in both commercial poultry and backyard birds. 

Notably, a commercial turkey farm in Swift County, Minnesota, that houses 34,000 birds is the site of the latest outbreak to hit the top turkey-producing state in the nation. 

Egg-laying farm hens in Indiana hit

In Indiana, an outbreak on a commercial egg-layer farm with 19,600 birds was reported in Lagrange County. Pennsylvania’s Lancaster County has noted two outbreaks of 1,200, and 2,800 birds, respectively. 

In Cascade and Yellowstone counties in Montana, two small backyard flocks were affected. And Idaho also reported detections on a farm in Payette County (11,600 birds) and in a 90-bird backyard flock in Canyon County. 

Avian flu activity is increasing across the county after relatively few detections this summer. In the past 30 days, confirmations have been made in 62 flocks, including 34 commercial flocks and 28 backyard flocks, with 6.46 million birds affected in the outbreaks.  

Minnesota has seen the highest jump in activity, with 17 commercial flocks, 2 backyard flocks, and almost 600,000 birds affected.