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0 0.5 1 1.5 2+ Mortality 87% Improvement Relative Risk Ramlall et al. Melatonin for COVID-19 INTUBATED PATIENTS Is very late treatment with melatonin beneficial for COVID-19? Retrospective 948 patients in the USA Lower mortality with melatonin (p<0.000001) Ramlall et al., medRxiv, doi:10.1101/2020.10.15.20213546 Favors melatonin Favors control

Melatonin is significantly associated with survival of intubated COVID-19 patients

Ramlall et al., medRxiv, doi:10.1101/2020.10.15.20213546 (Preprint)
Ramlall et al., Melatonin is significantly associated with survival of intubated COVID-19 patients, medRxiv, doi:10.1101/2020.10.15.20213546 (Preprint)
Oct 2020   Source   PDF  
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Retrospective 948 intubated patients, 196 treated with melatonin, showing lower mortality with treatment.
This study includes budesonide and melatonin.
risk of death, 86.9% lower, HR 0.13, p < 0.001, treatment 196, control 752, adjusted per study, multivariable, Cox proportional hazards.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Ramlall et al., 18 Oct 2020, retrospective, USA, preprint, 3 authors.
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Melatonin is significantly associated with survival of intubated COVID-19 patients
Vijendra Ramlall, Jason Zucker, Nicholas Tatonetti
Background Respiratory distress requiring intubation is the most serious complication associated with coronavirus disease 2019 . Methods In this retrospective study, we used survival analysis to determine whether or not mortality following intubation was associated with hormone exposure in patients treated at New York Presbyterian/ Columbia University Irving Medical Center. Here, we report the overall hazards ratio for each hormone for exposure before and after intubation for intubated and mechanically ventilated patients. Results Among the 189,987 patients, we identified 948 intubation periods across 791 patients who were diagnosed with COVID-19 or infected with SARS-CoV2 and 3,497 intubation periods across 2,981 patients who were not. Melatonin exposure after intubation was statistically associated with a positive outcome in COVID-19 (demographics and comorbidities adjusted HR: 0.131, 95% CI: 7.76E-02 -0.223, p-value = 8.19E-14) and non-COVID-19 (demographics and comorbidities adjusted HR: 0.278, 95% CI: 0.142 -0.542, p-value = 1.72E-04) intubated patients. Additionally, melatonin exposure after intubation was statically associated with a positive outcome in COVID-19 patients (demographics and comorbidities adjusted HR: 0.127, 95% CI: 6.01E-02 -0.269, p-value = 7.15E-08). Conclusions Melatonin exposure after intubation is significantly associated with a positive outcome in COVID-19 and non-COVID-19 patients. Additionally, melatonin exposure after intubation is significantly associated with a positive outcome in COVID-19 patients requiring mechanical ventilation. While our models account for many covariates, including clinical history and demographics, it is impossible to rule out confounding or collider biases within our population. Further study into the possible mechanism of this observation is warranted.
Competing interests The authors declare no competing interests.
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