Comment on "Colchicine may not be effective in COVID-19 infection; it may even be harmful?"
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CitationSenol, K. Comment on" Colchicine May Not Be Effective in COVID-19 Infection; It May Even Be Harmful?". Clinical rheumatology.
We read with great interest the report by Cure et al. which speculated that colchicine may not be effective in COVID-19 infection . The main argument of the authors is that colchicine may have not increased the intracellular pH enough and cannot prevent the binding of the virus to the target angiotensin converting enzyme 2(ACE2) receptors. Also, they suggest that colchicine may increase the risk of acute respiratory distress syndrome(ARDS) and disseminated intravascular coagulation(DIC) which may occur during COVID-19 infection. We have not agreed with the authors at these points. Fırst, the colchicine and anti-malarial drugs both may increase the intracellular pH by different mechanisms. There are no studies investigating the intracellular concentration of colchicine in corona infection, while such data exist regarding chloroquine . So, this view is only an author’s hypothesis that is not based on scientific data. Second, there is no any data supporting Cure et al. that colchicine increases the risk of ARDS and DIC in COVID-19 patients. On the contrary, we hypothesize that colchicine may protect rheumatic patients from COVID-19 or perhaps cause them to pass in a milder form of disease. COVID-19 is not only a viral infection, it is an autoinflammatory/autoimmune process that develops as a result of immune system dysfunction, cytokine release syndrome, and hemophagocytic lymphohistiocytosis . It acts by binding toACE2 receptors in target organs such as lung alveolar type 2 cells .When COVID-19 is passed into the cell via ACE2, activation of NLRP3 inflammasome is triggered by immunological mechanisms. The presence of high NLRP3- induced pro-inflammatory cytokines (IL-1, IL-1beta) in the sera of COVID-19 patients supports this hypothesis . Colchicine is an anti-inflammatory agent that inhibit the microtubule