{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T22:14:00Z","timestamp":1790115240347,"version":"4.0.1"},"reference-count":61,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Melatonin has demonstrated antioxidant, anti\u2010inflammatory, and potential antiviral properties. Its therapeutic role in critically ill COVID\u201019 patients admitted to intensive care was underexplored at the start of the pandemic. We conducted a quasi\u2010experimental, pragmatic study over 4 consecutive uninterrupted time periods alternating control groups receiving standard of care (SoC) with treatment groups receiving SoC plus high\u2010dose oral bedtime melatonin (50\u2013200\u2009mg) (OBM). The primary endpoint was 90\u2010day mortality; secondary outcomes included sequential organ failure assessment (SOFA) scores at 4, 7, 14, and 30 days and pre\u2010defined severe adverse events (SAEs). A total of 335 of 339 consecutive patients with a predicted stay &gt;\u200948\u2009h were enrolled; 202 received OBM with SoC and 133 received SoC alone. OBM was dispensed during the second (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009162) and fourth (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200940) study periods after the first (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200940) and third (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200993) control group periods, respectively. Melatonin therapy was associated with significantly lower 90\u2010day mortality (20.8% vs. 36.1%, OR 0.46, 95% CI 0.28\u20130.76). Subjects receiving melatonin had lower SOFA scores on Day 4 and subsequent study visits. SAEs occurred in 84 (41.6%) subjects on OBM and in 80 (60.2%) receiving SoC (risk ratio 0.68, 95% CI 0.54\u20130.87;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.001). High\u2010dose oral melatonin was safe and associated with improved clinical outcomes. Further evaluation of melatonin and its potential antiviral effects in future epidemics is warranted.\n                  <\/jats:p>","DOI":"10.1002\/jmv.70807","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T14:34:03Z","timestamp":1768401243000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Oral Melatonin in Critically Ill Patients With COVID\u201019: A Quasi\u2010Experimental Pragmatic Trial"],"prefix":"10.1002","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8775-255X","authenticated-orcid":false,"given":"Miguel","family":"S\u00e1nchez\u2010Garc\u00eda","sequence":"first","affiliation":[{"name":"Department of Critical Care Hospital Cl\u00ednico San Carlos Madrid Spain"},{"name":"Department of Medicine, Medical School Universidad Complutense Madrid Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jes\u00fas 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