key: cord-0908455-vl09tc6p
authors: Ilias, Ioannis; Milionis, Charalambos
title: COVID-19, colchicine and glycemia
date: 2021-02-18
journal: Med Hypotheses
DOI: 10.1016/j.mehy.2021.110547
sha: 3fe1d9f34c8c835e5b9783077f749fc5ab7ab5b8
doc_id: 908455
cord_uid: vl09tc6p

nan

There is mounting evidence that SARS-CoV-2 infection may lead to hyperglycemia (via compromised insulin secretion and lowered sensitivity to insulin) even in the absence of diabetes mellitus and with worsening of COVID-19 severity (1) (2) (3) (4) .

Colchicine was shown to reduce the duration of oxygen therapy and hospitalisation in 36 patients with COVID-19 (5). The same medication was also associated with less clinical deterioration, compared to controls, in 55 patients with COVID-19 (6). Very recently, preliminary results from the awaited COLCORONA trial (7) were presented: colchicine use at 1 mg/day maximum for 30 days was reported to be beneficial in mild to moderately ill patients with COVID-19 (n=4159), with significant reduction in need for hospitalization and possible reduction in need for mechanical ventilation or mortality (8) .

Colchicine at maximum daily doses of 1.5 mg has been associated with lower incidence of diabetes (9) and episodes of severe hypoglycemia (10, 11) . In sharp contrast, under experimental conditions, higher doses of colchicine of 2.0 mg/day for 10 days or up to 3.0 mg (bolus) have been associated with hyperglycemia and lowering of endogenous insulin secretion (12) . Thus, the effects of colchicine on glycemia appear to be biphasic, with lower doses leading to low blood glucose (or even hypoglycemia) and higher doses leading to hyperglycemia.

Consequently, we can speculate that the addition of colchicine to the current pharmaceutical armamentarium for COVID-19 (a disease which -apparently -is accompanied by changes in blood glucose) may impart further glycemic changes that necessitate vigilance.

Both Authors declare no conflict of interest.

Glycemia, Beta-Cell Function and Sensitivity to Insulin in Mildly to Critically Ill Covid-19 Patients

Clinical Study of Hyperglycemia and SARS-CoV-2 Infection in Intensive Care Unit Patients

Hyperglycemia and the novel Covid-19 infection: Possible pathophysiologic mechanisms

Outcomes in Patients With Hyperglycemia Affected by COVID-19: Can We Do More on Glycemic Control?

Beneficial effects of colchicine for moderate to severe COVID-19: a randomised, double-blinded, placebo-controlled clinical trial

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

Gout Pharmacotherapy in Cardiovascular Diseases: A Review of Utility and Outcomes

Efficacy of Colchicine in Non-Hospitalized Patients with COVID-19, medRxiv

Association Between Colchicine and Risk of Diabetes Among the Veterans Affairs Population With Gout

Hypoglycemia caused by colchicine

Colchicine Induced Hypoglycemia: A Case Report

Colchicine and insulin secretion in man