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Melatonin as adjunctive therapy in patients admitted to the Covid-19
Elahe Karimpour-Razkenari1, Fahimeh Naderi-Behdani1, Ali Salahshoor2
1Department of Clinical Pharmacy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran.
Insights
Melatonin supplementation did not significantly reduce mortality or improve key biochemical markers in intensive care unit (ICU) patients with coronavirus disease 2019 (COVID-19). However, it was well-tolerated and reduced the risk of thrombocytopenia.
Area of Science:
- Intensive care medicine
- Infectious diseases
- Pharmacology
Background:
- Coronavirus disease 2019 (COVID-19) has presented a global health crisis with limited specific treatments.
- Previous research indicated potential benefits of melatonin in sepsis and influenza, but its efficacy in severe COVID-19, particularly in the ICU setting, remained uncertain.
Purpose of the Study:
- To investigate the effects of melatonin administration on outcomes for patients admitted to the intensive care unit (ICU) with COVID-19.
Main Methods:
- A retrospective cohort study reviewed records of COVID-19 ICU patients from March to June 2020.
- Patients were divided into two groups: those receiving 15 mg of melatonin daily (MRG) and those not (NMRG).
- Demographic, clinical, and laboratory data were analyzed for comparison between groups.
Main Results:
- Melatonin did not significantly impact ICU duration, C-reactive protein (CRP), or erythrocyte sedimentation rate (ESR).
- Melatonin significantly reduced neutrophil-to-lymphocyte ratio (NLR) and the occurrence of thrombocytopenia.
- While mortality risk was marginally reduced in the melatonin group, the difference was not statistically significant, possibly due to the small sample size.
Conclusions:
- Melatonin is unlikely to be effective in reducing mortality among COVID-19 patients.
- The supplement showed no significant effect on disease-specific biochemical parameters but was well-tolerated.
- Further research with larger sample sizes may be warranted to explore potential benefits, particularly regarding non-mortality outcomes.
Objective:
Coronavirus has disrupted the natural order of the world since September 2019 with no specific medication. The beneficial effects of melatonin on sepsis and viral influenza were demonstrated previously, but its effects on covid-19, especially COVID -19 ICU, is unclear. Therefore, our aim was to determine the effects of melatonin in COVID-19 ICU patients.
Methods:
This is a retrospective cohort study in which the records of patients admitted to COVID -19 ICU of (XXX) during March to June 2020 were reviewed. According to inclusion criteria, patients who received 15 mg of melatonin daily were called MRG and the rest were called NMRG.
Results:
Thirty-one patients were included and analyzed, of which twelve patients were in MRG. Demographic and clinical characteristics, and laboratory data were similar between two groups at ICU admission. Melatonin had no significant effect on ICU duration, CRP and ESR, also the trend of changes was in favor of melatonin. Nevertheless, melatonin significantly reduced the NLR (OR = -9.81, p = 0.003), and also declined mortality marginally (p = 0.09). Melatonin was well tolerated with no major adverse effects, moreover the thrombocytopenia occurrence was significantly lower in MRG (p = 0.005). In MRG, survival increased and mortality risk decreased, although the difference between groups wasn't significant (p = 0.37), which might be related to the small sample-size.
Conclusion:
Our study showed that melatonin is unlikely to reduce mortality among COVID19 patients and with no significant effect on disease-specific biochemical parameters.
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