Inclusion Criteria:  Positive PCR for SARS-Cov-2 ICU admission < 48 hours Age 18 years or older Need for invasive or non-invasive ventilatory support (non-invasive ventilation or high-flow nasal cannula) < 48 hours  Exclusion Criteria:  Pregnancy or breastfeeding Refusal to sign the informed consent form Expected death in the next 24 hours Patients taking routinely SSRI or monoamine oxidase inhibitor therapy Impossibility of using the enteral route History of seizure disorder History of adverse reaction to antihistamines or to cyproheptadine Readmission to the ICU