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All Studies   Meta Analysis    Recent:   

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

Ramlall et al., medRxiv, doi:10.1101/2020.10.15.20213546
Oct 2020  
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0 0.5 1 1.5 2+ Mortality 71% Improvement Relative Risk Budesonide  Ramlall et al.  INTUBATED PATIENTS Is very late treatment with budesonide beneficial for COVID-19? Retrospective 948 patients in the USA Lower mortality with budesonide (p=0.014) c19early.org Ramlall et al., medRxiv, October 2020 Favors budesonide Favors control
Budesonide for COVID-19
18th treatment shown to reduce risk in April 2021
 
*, now known with p = 0.0000011 from 15 studies, recognized in 8 countries.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,200+ studies for 70+ treatments. c19early.org
Retrospective 948 intubated patients, 33 treated with budesonide, showing lower mortality with treatment.
Study covers budesonide and melatonin.
risk of death, 71.0% lower, HR 0.29, p = 0.01, treatment 33, control 915, 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.
This PaperBudesonideAll
Melatonin is significantly associated with survival of intubated COVID-19 patients
Vijendra Ramlall, Jason Zucker, Nicholas Tatonetti
doi:10.1101/2020.10.15.20213546
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.
References
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Geleris, Observation Study of Hydroxychloroquine in Hospitalized Patients with Covid-19, N. Engl. J. Med
Grady, Covid-19 Patient Gets Double Lung Transplant, Offering Hope for Others
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Here, we report the overall hazards ' 'ratio for each hormone for exposure before and after intubation for intubated and ' 'mechanically ventilated ' 'patients.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>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. 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Late treatment
is less effective
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