Pharmacological intervention Sample size and criteria Treatment protocol Key findings Conclusion Reference
• Colchicine for the improvement of cardiac biomarkers, inflammation, and clinical outcomes • Prospective, open-label randomized controlled trial (RCT)
•  N = 55 colchicine + standard care
•  N = 50 standard care
• Primary endpoints included maximum cardiac troponin level, time for C-reactive protein (CRP) to reach 3× upper limit normal, time to deterioration by at least 2 points on clinical status scale • Colchicine 1.5 mg loading dose, 0.5 mg after 60 min, and then 0.5 mg twice daily + standard care for up to 3 weeks • No difference in cardiac troponin or CRP levels
• Clinical deterioration less common with colchicine treatment odd ratio (OR) 0.11 (95% CI 0.01–0.96)
• Abdominal pain and diarrhea significantly more common with colchicine treatment • Colchicine may not have a significant effect on cardiac or inflammatory biomarkers, however it may be useful in stabilizing patients with severe COVID-19 infection and preventing clinical deterioration (Deftereos et al., 2020)
• Statin therapy and impact on inflammation and patient prognosis • Retrospective cohort study
• Primary endpoint of 28-day all-cause mortality
• Secondary endpoint included acute cardiac injury
•  N = 1219 statin use
•  N = 12, 762 no statin • In-hospital statin use
• Atorvastatin 83.2%,
• Rosuvastatin 15.6%
• Dose differences between statins were converted to a daily equivalent dose of atorvastatin ranging from 18.9–20.0 mg/day • Reduced all-cause mortality with statin use hazard ratio (HR) 0.63 (95% CI 0.48–0.84)
• Patients on ACEi/ARB therapy in addition to statin did not have increased mortality compared to statin alone
• Statin therapy not associated with acute cardiac injury
• Inflammatory markers CRP, IL-6 were lower in statin treated patients while in hospital • Reduced mortality and improved prognosis associated with in-hospital statin use may be due to the anti-inflammatory and immunomodulatory effects of statins (Zhang, Qin, Cheng, et al., 2020)
• ACEi/ARB impact on mortality in COVID-19 patients with concomitant hypertension • Retrospective, multi-centre cohort study
• Patients with comorbid hypertension hospitalized with COVID-19
• Age 18 to 74 years
• Primary endpoint of 28-day all-cause mortality
•  N = 188 ACEi/ARB therapy
•  N = 940 no ACEi/ARB • ACEi/ARB for treatment of hypertension
• individual patient dosing regimens not specified • Risk of all-cause mortality lower in ACEi/ARB treated group HR 0.42 (95% CI 0.19–0.92).
• Use of ACEi/ARB in comparison to other anti-hypertension therapies was associated with lower mortality HR 0.30 (95% CI 0.12–0.70).
• No difference in acute cardiac injury outcome between groups • Chronic ACEi/ARB therapy may not increase mortality of COVID-19 patients
• May not have much benefit in acute heart injury due to COVID-19 inflammation (Zhang, Zhu, Cai, et al., 2020)
• Statin use impact on acute myocardial injury patient outcomes • Retrospective observational cohort study
• Patients with elevated troponin
• History of CVD in 24% of patients
•  N = 3069
• Objective to characterize myocardial injury and associated outcomes • 36% of patients using statins
• Doses and regimens not specified • Statin use amongst patients with acute myocardial injury was associated with improved survival HR 0.57 (95% CI 0.47–0.69) • Statin treatment may be associated with a survival benefit in patients with CVD and elevated troponin levels
• Exact beneficial mechanism(s) associated with statins in COVID-19 remain to be studied (Lala et al., 2020)