Safety and efficacy of melatonin as an adjuvant therapy in COVID-19 patients: Systematic review and meta-analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of clinical trials including randomized controlled trials
PubMed 37742478 · doi:10.1016/j.advms.2023.09.007
What was done
Authors searched PubMed, Scopus, Cochrane Library, and Web of Science through December 2022 for studies evaluating melatonin as adjuvant therapy in COVID-19 patients. Meta-analyses across 11 included studies were performed using RevMan with fixed-effect or random-effects models depending on heterogeneity.
What was found
Across 11 studies: - Clinical improvement rate was significantly higher with melatonin (OR: 5.09; 95% CI: 2.60-9.96, p < 0.001). - Overall mortality difference was not statistically significant (OR: 0.37; 95% CI: 0.07-1.81, p = 0.22), but was significantly lower in the randomized controlled trial subgroup (OR: 0.17; 95% CI: 0.08-0.38, p < 0.001). - CRP levels decreased significantly (weighted mean difference [WMD] = -9.85; 95% CI: -18.54 to -1.16, p = 0.03). - Hospital length of stay was significantly shorter (WMD = -4.05; 95% CI: -5.39 to -2.7, p < 0.001). - Duration of mechanical ventilation was reported as shorter in the conclusion, but no numerical data were provided in the abstract.
Why it matters
Melatonin is an accessible, low-cost agent with anti-inflammatory properties that may accelerate recovery and improve outcomes when added to standard COVID-19 care.
Limits
Total participant count is not reported in the abstract. The meta-analysis combines randomized and non-randomized designs, yielding discordant overall versus subgroup mortality findings. Specific dosages, timing, safety outcomes, and patient disease severities are omitted from the abstract.
Cited by
- supports Melatonin administered as an adjunct therapy during COVID-19 infection improved clinical recovery outcomes.