Abstract:
Background: Serotonin is a mediator of pulmonary hypoxic vasoconstriction. Experimental studies have shown that serotonin-mediated
pulmonary vasoconstriction can be inhibited by cyproheptadine. The aim of this study is to assess whether treatment with cyproheptadine
compared to usual care increases ventilatory support-free days during the first 28 days in patients with coronavirus disease 2019 (COVID-19)
requiring ventilatory support.
Materials and methods: This randomized, single-center, open-label clinical trial included patients who were admitted to the intensive care
unit (ICU) requiring ventilatory support due to COVID-19. Patients allocated to the intervention group received cyproheptadine for 10 days.
The primary outcome was ventilator-free days during the first 28 days.
Results: Nineteen patients were randomized to receive cyproheptadine and 21 to the control group. The number of ventilatory support-free
days during the first 28 days was not different between the two groups (15.0; 95% CI, 0.0–24.0 days in the control group vs 7.0; 95% CI, 0.0–19.0
days in the intervention group; p = 0.284).
Conclusion: In patients with COVID-19 and in need of ventilatory support, the use of cyproheptadine plus usual care, compared with usual care
alone, did not increase the number of ventilatory support-free days in 28 days.
