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0 0.5 1 1.5 2+ ICU admission 81% Improvement Relative Risk Recovery time 49% Discharge 44% Time to discharge 43% Melatonin  Farnoosh et al.  LATE TREATMENT  DB RCT Is late treatment with melatonin beneficial for COVID-19? Double-blind RCT 44 patients in Iran (April - June 2020) Faster recovery with melatonin (p=0.004) Farnoosh et al., Archives of Medical R.., Jun 2021 Favors melatonin Favors control

Efficacy of a Low Dose of Melatonin as an Adjunctive Therapy in Hospitalized Patients with COVID-19: A Randomized, Double-blind Clinical Trial

Farnoosh et al., Archives of Medical Research, doi:10.1016/j.arcmed.2021.06.006
Jun 2021  
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Melatonin for COVID-19
10th treatment shown to reduce risk in December 2020
*, now known with p = 0.0000002 from 18 studies.
Lower risk for mortality, ventilation, and recovery.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
3,800+ studies for 60+ treatments.
RCT 44 hospitalized patients in Iran, 24 treated with melatonin, showing faster recovery with treatment. There was no mortality.
risk of ICU admission, 81.5% lower, RR 0.19, p = 0.20, treatment 0 of 24 (0.0%), control 2 of 20 (10.0%), NNT 10.0, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm).
recovery time, 49.0% lower, relative time 0.51, p = 0.004, treatment 24, control 20.
risk of no hospital discharge, 44.4% lower, RR 0.56, p = 0.65, treatment 2 of 24 (8.3%), control 3 of 20 (15.0%), NNT 15.
time to discharge, 42.9% lower, relative time 0.57, p = 0.02, treatment 24, control 20.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Farnoosh et al., 23 Jun 2021, Double Blind Randomized Controlled Trial, Iran, peer-reviewed, 12 authors, study period 25 April, 2020 - 5 June, 2020, average treatment delay 7.0 days.
This PaperMelatoninAll
Efficacy of a Low Dose of Melatonin as an Adjunctive Therapy in Hospitalized Patients with COVID-19: A Randomized, Double-blind Clinical Trial
Gholamreza Farnoosh, Mostafa Akbariqomi, Taleb Badri, Mahdi Bagheri, Morteza Izadi, Ali Saeedi-Boroujeni, Ehsan Rezaie, Hadi Esmaeili Gouvarchin Ghaleh, Hossein Aghamollaei, Mahdi Fasihi-Ramandi, Kazem Hassanpour, Gholamhossein Alishiri
Archives of Medical Research, doi:10.1016/j.arcmed.2021.06.006
Background. Melatonin has been known as an anti-inflammatory agent and immune modulator that may address progressive pathophysiology of coronavirus disease 2019 .Aim of the study. To evaluate the clinical efficacy of adjuvant, use of melatonin in patients with COVID-19. Methods. This single-center, double-blind, randomized clinical trial included 74 hospitalized patients with confirmed mild to moderate COVID-19 at Baqiyatallah Hospital in Tehran, Iran, from April 25, 2020-June 5, 2020. Patients were randomly assigned in a 1:1 ratio to receive standard of care and standard of care plus melatonin at a dose of 3 mg three times daily for 14 d. Clinical characteristics, laboratory, and radiological findings were assessed and compared between two study groups at baseline and post-intervention. Safety and clinical outcomes were followed up for four weeks. Results. A total of 24 patients in the intervention group and 20 patients in the control group completed the treatment. Compared with the control group, the clinical symptoms such as cough, dyspnea, and fatigue, as well as the level of CRP and the pulmonary involvement in the intervention group had significantly improved (p < 0.05). The mean time of hospital discharge of patients and return to baseline health was significantly shorter in the intervention group compared to the control group (p < 0.05). No deaths and adverse events were observed in both groups. Conclusions. Adjuvant use of melatonin has a potential to improve clinical symptoms of COVID-19 patients and contribute to a faster return of patients to baseline health.
ARTICLE IN PRESS Declaration of Competing Interests All authors have no conflict of interest to declare.
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Late treatment
is less effective
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