Methylene Blue for Treatment of Hospitalized COVID-19 Patients: A Randomized, Controlled, Open-Label Clinical Trial, Phase 2

ABSTRACT Background: There is no pharmacological intervention on the treatment of hypoxemia and respiratory distress in COVID-19 patients. Objective: The objective of the study was to study the effect of the reduced form of methylene blue (MB) on the improvement of oxygen saturation (SpO2) and respiratory rate (RR). Methods: In an academic medical center, 80 hospitalized patients with severe COVID-19 were randomly assigned to receive either oral MB along with standard of care (SOC) (MB group, n = 40) or SOC only (SOC group, n=40). The primary outcomes were SpO2 and RR on the 3rd and 5th days. The secondary outcomes were hospital stay and mortality within 28 days. Results: In the MB group, a significant improvement in SpO2 and RR was observed on the 3rd day (for both, p < 0.0001) and also the 5th day (for both, p < 0.0001). In the SOC group, there was no significant improvement in SpO2 (p = 0.24) and RR (p = 0.20) on the 3rd day, although there was a significant improvement of SpO2 (p = 0.002) and RR (p = 0.01) on the 5th day. In the MB group in comparison to the SOC group, the rate ratio of increased SpO2 was 13.5 and 2.1 times on the 3rd and 5th days, respectively. In the MB group compared with the SOC group, the rate ratio of RR improvement was 10.1 and 3.7 times on the 3rd and 5th days, respectively. The hospital stay was significantly shortened in the MB group (p = 0.004), and the mortality was 12.5% and 22.5% in the MB and SOC groups, respectively. Conclusions: The addition of MB to the treatment protocols significantly improved SpO2 and respiratory distress in COVID-19 patients, which resulted in decreased hospital stay and mortality. ClinicalTrials.gov: NCT04370288

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Main Authors: Hamidi-Alamdari,Daryoush, Hafizi-Lotfabadi,Saied, Bagheri-Moghaddam,Ahmad, Safari,Hossin, Mozdourian,Mahnaz, Javidarabshahi,Zahra, Peivandi-Yazdi,Arash, Ali-Zeraati,Abass, Sedaghat,Alireza, Poursadegh,Farid, Barazandeh-Ahmadabadi,Fatemeh, Agheli-Rad,Marzieh, Tavousi,Seyed M., Vojouhi,Shohreh, Amini,Shahram, Amini,Mahnaz, Majid-Hosseini,Seyed, Tavanaee-Sani,Ashraf, Ghiabi,Amin, Nabavi-Mahalli,Shima, Morovatdar,Negar, Rajabi,Omid, Koliakos,George
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Published: Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán 2021
Online Access:http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0034-83762021000300190
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spelling oai:scielo:S0034-837620210003001902021-06-22Methylene Blue for Treatment of Hospitalized COVID-19 Patients: A Randomized, Controlled, Open-Label Clinical Trial, Phase 2Hamidi-Alamdari,DaryoushHafizi-Lotfabadi,SaiedBagheri-Moghaddam,AhmadSafari,HossinMozdourian,MahnazJavidarabshahi,ZahraPeivandi-Yazdi,ArashAli-Zeraati,AbassSedaghat,AlirezaPoursadegh,FaridBarazandeh-Ahmadabadi,FatemehAgheli-Rad,MarziehTavousi,Seyed M.Vojouhi,ShohrehAmini,ShahramAmini,MahnazMajid-Hosseini,SeyedTavanaee-Sani,AshrafGhiabi,AminNabavi-Mahalli,ShimaMorovatdar,NegarRajabi,OmidKoliakos,George COVID-19 Treatment Methylene Blue Hypoxemia Mortality ABSTRACT Background: There is no pharmacological intervention on the treatment of hypoxemia and respiratory distress in COVID-19 patients. Objective: The objective of the study was to study the effect of the reduced form of methylene blue (MB) on the improvement of oxygen saturation (SpO2) and respiratory rate (RR). Methods: In an academic medical center, 80 hospitalized patients with severe COVID-19 were randomly assigned to receive either oral MB along with standard of care (SOC) (MB group, n = 40) or SOC only (SOC group, n=40). The primary outcomes were SpO2 and RR on the 3rd and 5th days. The secondary outcomes were hospital stay and mortality within 28 days. Results: In the MB group, a significant improvement in SpO2 and RR was observed on the 3rd day (for both, p < 0.0001) and also the 5th day (for both, p < 0.0001). In the SOC group, there was no significant improvement in SpO2 (p = 0.24) and RR (p = 0.20) on the 3rd day, although there was a significant improvement of SpO2 (p = 0.002) and RR (p = 0.01) on the 5th day. In the MB group in comparison to the SOC group, the rate ratio of increased SpO2 was 13.5 and 2.1 times on the 3rd and 5th days, respectively. In the MB group compared with the SOC group, the rate ratio of RR improvement was 10.1 and 3.7 times on the 3rd and 5th days, respectively. The hospital stay was significantly shortened in the MB group (p = 0.004), and the mortality was 12.5% and 22.5% in the MB and SOC groups, respectively. Conclusions: The addition of MB to the treatment protocols significantly improved SpO2 and respiratory distress in COVID-19 patients, which resulted in decreased hospital stay and mortality. ClinicalTrials.gov: NCT04370288info:eu-repo/semantics/openAccessInstituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránRevista de investigación clínica v.73 n.3 20212021-06-01info:eu-repo/semantics/articletext/htmlhttp://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0034-83762021000300190en10.24875/ric.21000028
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countrycode MX
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databasecode rev-scielo-mx
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region America del Norte
libraryname SciELO
language English
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author Hamidi-Alamdari,Daryoush
Hafizi-Lotfabadi,Saied
Bagheri-Moghaddam,Ahmad
Safari,Hossin
Mozdourian,Mahnaz
Javidarabshahi,Zahra
Peivandi-Yazdi,Arash
Ali-Zeraati,Abass
Sedaghat,Alireza
Poursadegh,Farid
Barazandeh-Ahmadabadi,Fatemeh
Agheli-Rad,Marzieh
Tavousi,Seyed M.
Vojouhi,Shohreh
Amini,Shahram
Amini,Mahnaz
Majid-Hosseini,Seyed
Tavanaee-Sani,Ashraf
Ghiabi,Amin
Nabavi-Mahalli,Shima
Morovatdar,Negar
Rajabi,Omid
Koliakos,George
spellingShingle Hamidi-Alamdari,Daryoush
Hafizi-Lotfabadi,Saied
Bagheri-Moghaddam,Ahmad
Safari,Hossin
Mozdourian,Mahnaz
Javidarabshahi,Zahra
Peivandi-Yazdi,Arash
Ali-Zeraati,Abass
Sedaghat,Alireza
Poursadegh,Farid
Barazandeh-Ahmadabadi,Fatemeh
Agheli-Rad,Marzieh
Tavousi,Seyed M.
Vojouhi,Shohreh
Amini,Shahram
Amini,Mahnaz
Majid-Hosseini,Seyed
Tavanaee-Sani,Ashraf
Ghiabi,Amin
Nabavi-Mahalli,Shima
Morovatdar,Negar
Rajabi,Omid
Koliakos,George
Methylene Blue for Treatment of Hospitalized COVID-19 Patients: A Randomized, Controlled, Open-Label Clinical Trial, Phase 2
author_facet Hamidi-Alamdari,Daryoush
Hafizi-Lotfabadi,Saied
Bagheri-Moghaddam,Ahmad
Safari,Hossin
Mozdourian,Mahnaz
Javidarabshahi,Zahra
Peivandi-Yazdi,Arash
Ali-Zeraati,Abass
Sedaghat,Alireza
Poursadegh,Farid
Barazandeh-Ahmadabadi,Fatemeh
Agheli-Rad,Marzieh
Tavousi,Seyed M.
Vojouhi,Shohreh
Amini,Shahram
Amini,Mahnaz
Majid-Hosseini,Seyed
Tavanaee-Sani,Ashraf
Ghiabi,Amin
Nabavi-Mahalli,Shima
Morovatdar,Negar
Rajabi,Omid
Koliakos,George
author_sort Hamidi-Alamdari,Daryoush
title Methylene Blue for Treatment of Hospitalized COVID-19 Patients: A Randomized, Controlled, Open-Label Clinical Trial, Phase 2
title_short Methylene Blue for Treatment of Hospitalized COVID-19 Patients: A Randomized, Controlled, Open-Label Clinical Trial, Phase 2
title_full Methylene Blue for Treatment of Hospitalized COVID-19 Patients: A Randomized, Controlled, Open-Label Clinical Trial, Phase 2
title_fullStr Methylene Blue for Treatment of Hospitalized COVID-19 Patients: A Randomized, Controlled, Open-Label Clinical Trial, Phase 2
title_full_unstemmed Methylene Blue for Treatment of Hospitalized COVID-19 Patients: A Randomized, Controlled, Open-Label Clinical Trial, Phase 2
title_sort methylene blue for treatment of hospitalized covid-19 patients: a randomized, controlled, open-label clinical trial, phase 2
description ABSTRACT Background: There is no pharmacological intervention on the treatment of hypoxemia and respiratory distress in COVID-19 patients. Objective: The objective of the study was to study the effect of the reduced form of methylene blue (MB) on the improvement of oxygen saturation (SpO2) and respiratory rate (RR). Methods: In an academic medical center, 80 hospitalized patients with severe COVID-19 were randomly assigned to receive either oral MB along with standard of care (SOC) (MB group, n = 40) or SOC only (SOC group, n=40). The primary outcomes were SpO2 and RR on the 3rd and 5th days. The secondary outcomes were hospital stay and mortality within 28 days. Results: In the MB group, a significant improvement in SpO2 and RR was observed on the 3rd day (for both, p < 0.0001) and also the 5th day (for both, p < 0.0001). In the SOC group, there was no significant improvement in SpO2 (p = 0.24) and RR (p = 0.20) on the 3rd day, although there was a significant improvement of SpO2 (p = 0.002) and RR (p = 0.01) on the 5th day. In the MB group in comparison to the SOC group, the rate ratio of increased SpO2 was 13.5 and 2.1 times on the 3rd and 5th days, respectively. In the MB group compared with the SOC group, the rate ratio of RR improvement was 10.1 and 3.7 times on the 3rd and 5th days, respectively. The hospital stay was significantly shortened in the MB group (p = 0.004), and the mortality was 12.5% and 22.5% in the MB and SOC groups, respectively. Conclusions: The addition of MB to the treatment protocols significantly improved SpO2 and respiratory distress in COVID-19 patients, which resulted in decreased hospital stay and mortality. ClinicalTrials.gov: NCT04370288
publisher Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán
publishDate 2021
url http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0034-83762021000300190
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