High Colchicine Doses Are More Effective in COVID-19 Outpatients than Nirmatrelvir/Ritonavir, Remdesivir, and Molnupiravir

Colchicine has an excellent basis for being effective against COVID-19 due to its anti-inflammatory, immunomodulatory, cardioprotective effects, and prevention of microvascular thrombosis. In addition colchicine has also antiviral effect, extremely favorable safety profile and since it does not exert any overt immunosuppressive activity, does not interfere with the effective viral clearing nor is associated with the occurrence of secondary infections.However, all studies to date on the effects of colchicine with low doses for COVID-19 treatment are conflicting and rather disappointing.As colchicine has the remarkable ability to accumulate intensively in leukocytes, where the cytokine storm is generated, we started high, but save doses colchicine for COVID-19 patient treatment. Our assumption was that a safe increase in colchicine doses to reach micromolar concentrations in leukocytes will result in NLRP3 inflammasome/cytokine storm inhibition and will enhance its antiviral effect by inducing microtubule dissociation.Outpatients’ high-dose colchicine treatment practically prevents hospitalizations. The total colchicine uptake analysis demonstrates reverse relationship with hospitalization. The period of colchicine uptake analysis demonstrates reverse relationship with hospitalization and post-COVID-19 symptomatics. Unlike the WHO-recommended antiviral preparations molnupiravir, remdesivir and paxlovid, colchicine, in addition to its antiviral effect, prevents the cytokine storm, and therefore has a strong effect not only in outpatients, but also in inpatients. Unlike antivirals, colchicine significantly reduces post-COVID-19 symptoms. The side effects of colchicine are similar to those of paxlovide. Colchicine price is incomparably lower and it is also easily available.