Evidence map›Paper›PMID 39207597›Full record

Trial reportNaunyn-Schmiedeberg's archives of pharmacology2025

Methylene blue for COVID-19 ARDS: insights from a randomized Clinical Trial.

Zahra Sadat Sanei, Fatemeh Shahrahmani, Behrooz Khaleghi Manesh, Daryoush Hamidi-Alamdari, Hassan Mehrad-Majd, Behzad Mavaji Darban, Seyedeh Motahareh Mirdoosti, Mohsen Seddigh-Shamsi

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Naunyn-Schmiedeberg's archives of pharmacology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Zahra Sadat SaneiDepartment of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Fatemeh ShahrahmaniStudent Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.
Behrooz Khaleghi ManeshDepartment of Hematology-Oncology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Daryoush Hamidi-AlamdariSurgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Hassan Mehrad-MajdClinical Research Development Unit, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Behzad Mavaji DarbanSurgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Seyedeh Motahareh MirdoostiStudent Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.
Mohsen Seddigh-ShamsiDepartment of Hematology-Oncology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. seddighshamsim@mums.ac.ir.

Funding

Mashhad University of Medical Sciences 4000078
6 · The paper itself

Abstract

backgroundAround the world, the COVID-19 pandemic has presented many difficulties, and acute respiratory distress syndrome (ARDS) has become a major worry. The antiviral and anti-inflammatory characteristics of methylene blue (MB) have garnered interest for potential medicinal applications. The object of the current study is to assess the effect of orally administered MB on the treatment of ARDS associated with COVID-19.

methodA randomized clinical study was carried out on 122 hospitalized patients who had ARDS related to COVID-19. Patients who met the eligibility requirements were randomized at random to either the control group (CG) (n = 60) or the intervention group (IG) (n = 62). Standard treatments were administered to both groups, with the addition of oral MB to the IG. Clinical outcomes, including SpO2 levels, CRP levels were assessed on the third and fifth days. Additionally, at the time of discharge, patients' assessments were made in terms of APACHE II scores, SOFA scores, LDH and CRP levels, SpO2, and respiratory rate in comparison to the day prior to the intervention. Patients were followed for mortality outcomes at one month and three months after the intervention.

resultsSignificant changes were observed in SpO2 levels over time (P < 0.001) and between groups (P = 0.022), with higher levels in the MB-treated group. The interaction between time and group (P = 0.019) indicated a stronger increase in SpO2 in the IG, with the IG's SpO2 level increasing by 6.42%. Furthermore, CRP levels showed significant changes over time (P < 0.001), but not between groups (P = 0.092). However, the interaction between group and CRP change over time (P = 0.019) suggested a distinct pattern of CRP decrease in the IG. Significant improvement in RR, SpO2, CRP, and APACHE II score were found according to discharge results. However, in terms of SpO2 and the APACHE II score, this improvement was noteworthy for IG. The length of hospitalization and mortality rates at one- and three-month follow-ups did not differ significantly.

conclusionOral administration of MB demonstrated positive effects on improving SpO2 levels and reducing inflammatory markers in COVID-19-related ARDS patients. Despite no significant impact on survival rates or hospitalization length, the study supports the potential efficacy of MB as an alternative treatment for COVID-19 ARDS.

trial registrationThis study was registered with the Iranian Registry of Clinical Trials ( http://www.irct.ir ) under the registration code IRCT20200409047007N2 on 11/29/2021.

Indexed as

Anti-Inflammatory AgentsAntiviral AgentsCOVID-19 Drug TreatmentMethylene BlueRespiratory Distress SyndromeAdministration, OralAdultAgedCOVID-19C-Reactive ProteinFemaleHumansMaleMiddle AgedTreatment OutcomeAnti-Inflammatory AgentsAntiviral AgentsC-Reactive ProteinMethylene BlueARDSCOVID-19Methylene blue

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.