Benefits of melatonin on mortality in severe-to-critical COVID-19 patients: A systematic review and meta-analysis of randomized controlled trials
Jinlv Qin, Guizuo Wang, Dong Han
Clinics, doi:10.1016/j.clinsp.2025.100638
Objective: This meta-analysis aimed to determine the efficacy of melatonin on mortality in patients with severeto-critical illness COVID-19. Methods: A systematic search was made of PubMed, Embase, Cochrane Library, and clinicaltrials.gov, without language restrictions. Randomized Controlled Trials (RCTs) on the treatment of severe-to-critical COVID-19 with melatonin, compared with placebo or blank, were reviewed. Studies were pooled to Odds Ratios (ORs), with 95 % Confidence Intervals (95 % CIs). Results: Three RCTs (enrolling 451 participants) met the inclusion criteria. Melatonin showed a significant effect on in-hospital mortality (OR = 0.19, 95 % CI 0.05 to 0.74; p = 0.02). Conclusions: Melatonin significantly reduced in-hospital mortality in patients with severe-to-critical COVID-19. Melatonin should be considered for severe-to-critical COVID-19 patients.
Ethics approval and consent to participate Not applicable.
Consent for publication Not applicable.
Authors' contributions All authors, led by D.H., were involved in the concept and protocol design of the meta-analysis. J.Q. and G.W. screened the titles and abstracts and extracted data from the articles. J.Q. was primarily responsible for statistical analyses. G.W. was primarily involved in the interpretation of the quality data. All authors contributed to interpreting the results. J.Q. and D.H accessed and verified the data. All authors contributed to the writing of the article and approved its submission. D. H. was responsible for the decision to submit the article.
Conflicts of interest The authors declare no conflicts of interest.
Supplementary materials Supplementary material associated with this article can be found, in the online version, at doi:10.1016/j.clinsp.2025.100638.
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