Colchicine Fails to Improve Outcomes in Long COVID Patients: JAMA
According to a randomized clinical trial, colchicine did not enhance functional capacity, respiratory function, or reduce inflammation in adults with long COVID, highlighting the need for alternative treatments. The study was published in JAMA Internal Medicine by Abhinav B. and colleagues. Long COVID is characterized by chronic symptoms persisting for weeks or months following the initial illness. It is thought to be caused by persistent inflammation and immune dysregulation. Colchicine, a drug that has widespread use in gout and other inflammatory conditions, was postulated to reduce these symptoms through the inhibition of inflammatory pathways.
This prospective, double-blind, 1:1 randomized clinical trial involved adults with laboratory-confirmed SARS-CoV-2 infection who were still having functional limitations or had raised inflammatory markers. Participants were recruited if they had a Post–COVID-19 Functional Status (PCFS) grade of 2 or above and/or high-sensitivity C-reactive protein (hs-CRP) level of more than 0.20 mg/dL or a neutrophil-to-lymphocyte ratio (NLR) of more than 5. There were 346 participants included in the modified intention-to-treat analysis, with 209 (60.4%) being female and 137 (39.6%) male participants and a mean (SD) age of 46 (12) years. Patients were randomly allocated to receive either colchicine (0.5 mg once or twice daily depending on body weight) or placebo for 26 weeks. Outcomes were measured at 12, 26, and 52 weeks from randomization, with data analysis being done between January and February 2025.
Results
There was no significant difference in functional improvement at 52 weeks between the colchicine and placebo groups.
The mean (SD) 6-minute walk test (6MWT) distance change was 35.5 (19.76) meters with colchicine and 29.96 (19.83) meters with the placebo, resulting in a mean difference of 5.59 meters (95% CI, –9.00 to 20.18; P = 0.45).
This shows that colchicine did not make a clinically relevant improvement in exercise tolerance.
In addition, the same null findings were noted for secondary outcomes such as inflammatory markers and quality of life, anxiety, depression, fatigue, and dyspnea reported by patients.
The one statistically significant difference recorded was a small, clinically unimportant change in the ratio of forced expiratory volume in 1 second (FEV₁) to forced vital capacity (FVC): colchicine experienced a mean (SD) change of −0.02 (0.03) vs −0.06 (0.03) in the placebo group (mean difference, 0.04; 95% CI, 0.02–0.07; P = 0.001).
In this large, randomized trial, colchicine was not shown to have any meaningful benefit for enhancing functional capacity, respiratory function, or inflammatory markers in adults with long COVID. These observations indicate that colchicine is not a useful therapeutic intervention for long COVID and strengthen the importance of recognizing other treatment modalities to relieve the long-term impact of post-COVID-19 symptoms.
Reference:
Bassi A, Devasenapathy N, Thankachen SS, et al. Effectiveness of Colchicine for the Treatment of Long COVID: A Randomized Clinical Trial. JAMA Intern Med. Published online October 20, 2025. doi:10.1001/jamainternmed.2025.5408
