LAUSR

We read with interest the article from Scarsi and colleagues about the efficacy of colchicine in hospitalised patients with severe COVID-19.1 Colchicine is an ‘old drug’ originally approved for the treatment of gout and subsequently repositioned in numerous disease settings characterised by systemic inflammation and uncontrolled activation of the innate immune response.2 3 During the recent outbreak of SARS-CoV-2 infection, uncontrolled release of major proinflammatory cytokines such as interleukin (IL)-1 and IL-6 soon emerged as a major pathological feature of COVID-19 as well as a predictor of patients’ morbidity and mortality.4 5 Based on this evidence, hospitalised patients with severe COVID-19 are currently being treated with anti-cytokine biological drugs including the IL-1 receptor antagonist anakinra, the anti-granulocyte-macrophage colony-stimulating factor mavrilimumab and the IL-6 receptor blockers tocilizumab and sarilumab.6–9 Yet, although these targeted approaches have provided encouraging results in preliminary retrospective cohorts, they do not seem to induce a prompt recovery as optimistically expected, likely because administered at …