Melatonin as adjunctive therapy in patients admitted to the Covid-19

Elahe Karimpour-Razkenari; Fahimeh Naderi-Behdani; Ali Salahshoor; Fatemeh Heydari; Abbas Alipour; Afshin Gholipour Baradari

doi:10.1016/j.amsu.2022.103492

Melatonin as adjunctive therapy in patients admitted to the Covid-19

Ann Med Surg (Lond). 2022 Mar 10:76:103492. doi: 10.1016/j.amsu.2022.103492. eCollection 2022 Apr.

Authors

Elahe Karimpour-Razkenari¹, Fahimeh Naderi-Behdani¹, Ali Salahshoor², Fatemeh Heydari², Abbas Alipour³, Afshin Gholipour Baradari⁴

Affiliations

¹ Department of Clinical Pharmacy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran.
² Department of Anesthesiology and Critical Care Medicine, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran.
³ Community Medicine Department, Medical Faculty, Mazandaran University of Medical Sciences, Sari, Iran.
⁴ Professor of Anesthesiology and critical care, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.

Abstract

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.

Keywords: COVID -19; Melatonin; Mortality; Thrombocytopenia.