This study aimed to help determine the effect of dietary supplements on symptom course and quality of life in patients with mild-to-moderate COVID-19 infection.Design: We modified the Wisconsin Upper Respiratory Symptom Survey (WURSS) to conduct a 3 arm, parallel, randomized, double-blind, placebo-controlled trial, enrolling patients with mild-to-moderate symptoms of COVID-19 infection. Patients took placebo (n = 34), vitamin C 1000 mg (n = 32), or melatonin 10 mg (n = 32) orally for 14 days.Outcomes: Ninety Eight (98 out of 104 recruited; mean age = 52 years) patients completed the study. Outcomes were calculated as differences from baseline scores on each of 2 WURSS-derived surveys and analyzed using a spline regression analysis. Regarding symptom progression, those patients taking placebo and vitamin C progressed at the same rate. When compared with those taking placebo (coefficient = -1.09 (95% confidence interval [CI] = -1.39 to -0.8) the group taking melatonin had a faster resolution of symptoms (coefficient = -0.63 [95% CI -1.02 to -0.21] P = .003). By day 14 all 3 groups had reached plateau.Quality-of-life impact analysis demonstrated that the group taking vitamin C improved at the same rate as the group taking placebo (coefficient = -0.71 (95% CI = -1.11 to -0.3)). The group taking melatonin (coefficient = -1.16 (95% CI = -1.75 to -0.57) P < .005) had a faster improvement in quality-oflife. By day 14 all 3 groups had reached plateau.Conclusion: Vitamin C 1000 mg once daily has no effect on disease progression. Melatonin 10 mg daily may have a statistically significant effect but it is unclear if this represents a clinically significant benefit to those with mild-to-moderate symptoms of COVID-19 infection. Further study is warranted. ( J Am Board Fam Med 2022;35:695-707.

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Not everything that is given is a gift. Yet I offer her some solace, however limited, that what she has can be treated. Unsolicited, I write her a refill to give her partner, like me, a part of what she's built about herself, a patch within her quilt. Afterward, I spare a moment, split the blinds to stare a moment out my clinic window and consider something almost inexplicable, that sometimes the community understands a need before the individual.The sun burns, unfeeling, the wind blows or waits, uncaring. Everywhere, in fact, there are forces of nature, against which we shelter, create a pocket. Where there may have been only doubt we can fold our fabric and stitch a seam, turn our suffering inside out.And although what we do often goes unseen by those whose fear leads to hiding, at times each of us feels uninvited, so we make space and continue inviting.

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Nothing is merely black and white, she thought, on finding her patient's soul woundedsuffering from absence, suffering from excessand in his he agreed to take in the space of Ansel Adams, majestic peaks eclipsed by thunderheads so grand they can bring rain to desert eyes.

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