Karimpour-Razkenari Elahe, Naderi-Behdani Fahimeh, Salahshoor Ali, Heydari Fatemeh, Alipour Abbas, Baradari Afshin Gholipour
Department of Clinical Pharmacy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran.
Department of Anesthesiology and Critical Care Medicine, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran.
Ann Med Surg (Lond). 2022 Mar 10;76:103492. doi: 10.1016/j.amsu.2022.103492. eCollection 2022 Apr.
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.
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.
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.
Our study showed that melatonin is unlikely to reduce mortality among COVID19 patients and with no significant effect on disease-specific biochemical parameters.
自2019年9月以来，冠状病毒扰乱了世界的自然秩序，且尚无特效药物。褪黑素对脓毒症和病毒性流感的有益作用先前已得到证实，但其对新冠病毒疾病，尤其是新冠病毒疾病重症监护病房（COVID-19 ICU）患者的影响尚不清楚。因此，我们的目的是确定褪黑素对COVID-19 ICU患者的影响。
这是一项回顾性队列研究，回顾了2020年3月至6月期间入住（XXX）的COVID-19 ICU患者的记录。根据纳入标准，每天接受15毫克褪黑素治疗的患者被称为褪黑素治疗组（MRG），其余患者被称为非褪黑素治疗组（NMRG）。
共纳入31例患者进行分析，其中12例患者属于MRG。两组患者入住ICU时的人口统计学和临床特征以及实验室数据相似。褪黑素对ICU住院时间、CRP和ESR无显著影响，且变化趋势有利于褪黑素。然而，褪黑素显著降低了中性粒细胞与淋巴细胞比值（OR = -9.81，p = 0.003），且死亡率略有下降（p = 0.09）。褪黑素耐受性良好，无重大不良反应，此外，MRG中血小板减少症的发生率显著较低（p = 0.005）。在MRG中，生存率有所提高，死亡风险有所降低，尽管两组之间的差异不显著（p = 0.37），这可能与样本量较小有关。
我们的研究表明，褪黑素不太可能降低COVID-19患者的死亡率，且对疾病特异性生化参数无显著影响。
