Melatonin-COVID-19: Columbia University Study Shows That Melatonin Increases Survival Rates Of COVID-19 Patients On Ventilators
: Columbia University researchers have in a new study showed that COVID-19 patients requiring intubation and mechanical ventilation due to respiratory distress may benefit from treatment with the hormone melatonin as the survival rates are greatly increased.
The study findings were published on a preprint server and are currently being reviewed. https://www.medrxiv.org/content/10.1101/2020.10.15.20213546v1
The neuro-hormone melatonin is produced in the brain mainly at night as it prepares the body for sleep and is, therefore, sometimes referred to as the "sleep hormone."
In this retrospective analysis of patients who sought care at New York-Presbyterian/Columbia University Irving Medical Center, co-researcher Dr Nicholas Tatonetti found exposure to melatonin following endotracheal intubation was significantly associated with a positive survival outcome in both COVID-19 and non-COVID-19 patients.
Significantly, melatonin exposure following intubation was also associated with a positive survival outcome among patients with COVID-19 who required mechanical ventilation
. However, no such benefit was observed among non-COVID-19 patients who required mechanical ventilation.
The study team says this suggests that melatonin may target SARS-CoV-2-induced inflammation in the most severe cases of COVID-19.
The researchers say further studies are needed to investigate the possible mechanisms underlying these observations.
It has been found that following infection with SARS-CoV-2, most individuals commonly develop symptoms including fever, cough, fatigue, shortness of breath, and loss of taste or smell.
Less common and more severe symptoms that are influenced by the presence of comorbidities can also develop.
To date, the most severe symptom is respiratory distress, which, in the most severe cases, may require endotracheal intubation, mechanical ventilation, and potentially even lung transplant.
So far among the candidate therapies that researchers have been investigating for the treatment of COVID-19, steroid drugs such as dexamethasone have shown promising results. A study of dexamethasone carried out by the RECOVERY Collaborative Group in the UK found that compared with usual care, treatment with dexamethasone lowered the mortality rate among patients who required invasive mechanical ventilation and patients who received oxygen without mechanical ventilation.
Interestingly it was also found that having a history of asthma and respiratory disease is significantly associated with a positive outcome following intubation
This retrospective study of 189,987 patients who sought care at NYP/CUIMC between February 1st, 2020, and August 1st, 2020 underwent survival analysis to determine whether exposure to the "sleep hormone" melatonin following intubation was associated with mortality among intubated and mechanically ventilated patients.
The study team identified 948 periods of intubation periods across 791 patients who had COVID-19 or were infected with SARS-CoV2 and 3,497
intubation periods across 2,981 patients who did not have COVID-19 or SARS-CoV-2.
A detailed multivariate analysis that accounted for demographic factors and clinical diagnoses revealed that melatonin exposure following intubation was significantly associated with a positive survival outcome among both COVID-19 patients and non-COVID-19 patients.
In addition, melatonin exposure following intubation was also significantly associated with a positive survival outcome among mechanically ventilated COVID-19 patients, but not among mechanically ventilated patients who did not have COVID-19.
Dr Tatonetti added, "While our analysis identified significant associations between melatonin exposure after intubation and survival, we have not identified the directionality nor the underlying mechanism.”
The association between exposure to melatonin following intubation and patient survival in a multivariate model of COVID-19 and non-COVID-19 patients suggests that melatonin exposure does not specifically attenuate inflammation that arises from SARS-CoV-2 infection, says the study team.
The fact that exposure to melatonin following intubation that also required mechanical ventilation was only associated with a positive outcome in COVID-19 patients suggests that melatonin's mechanism of action in the most severe cases of COVID-19 may be targeted to SARS-CoV-2 induced inflammation, adds the team.
The study team concluded, "While melatonin is a popular over-the-counter sleep aid, our results lend support to the need for further follow-up into the mechanism of action of how melatonin may attenuate inflammation and specifically more studies into the observed association in severely affected COVID-19 patients.”
In early May, Thailand Medical News had also published an article about the merits of melatonin for treating COVID-19. https://www.thailandmedical.news/news/breaking-covid-19-supplements-melatonin-helps-lessen-severity-risk-in-covid-19-patients-by-preventing-cytokine-storms
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