COVID-19: Melatonin as a potential adjuvant treatment

• Published in: Life sciences (1973) Vol. 250; pp. 117583 - 6
• Main Authors: Zhang, Rui, Wang, Xuebin, Ni, Leng, Di, Xiao, Ma, Baitao, Niu, Shuai, Liu, Changwei, Reiter, Russel J.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01-06-2020; Elsevier BV; Published by Elsevier Inc
• Subjects: Acute Lung Injury - virology; Adjuvant therapy; Adjuvants, Immunologic - therapeutic use; Anti-Inflammatory Agents - therapeutic use; Antioxidants - therapeutic use; Attenuation; Betacoronavirus; Coronavirus Infections - drug therapy; Coronavirus Infections - immunology; Coronaviruses; COVID-19; COVID-19 Drug Treatment; Cytokine storm; Cytokines; Cytokines - immunology; Humans; Immune response; Immunomodulation; Inflammation; Inflammation - drug therapy; Melatonin; Melatonin - therapeutic use; Oxidation; Oxidation-reduction; Pandemics; Pathogenesis; Pathogens; Pathology; Patients; Permeability; Pneumonia, Viral - drug therapy; Pneumonia, Viral - immunology; Respiratory diseases; Respiratory distress syndrome; Respiratory Distress Syndrome - virology; SARS-CoV-2; Viral diseases; Viruses; COVID-19; SARS-CoV-2; Melatonin; Cytokines; Immunomodulation; Oxidation-reduction
• ISSN: 0024-3205; 1879-0631; 1879-0631
• DOI: 10.1016/j.lfs.2020.117583

This article summarizes the likely benefits of melatonin in the attenuation of COVID-19 based on its putative pathogenesis. The recent outbreak of COVID-19 has become a pandemic with tens of thousands of infected patients. Based on clinical features, pathology, the pathogenesis of acute respiratory disorder induced by either highly homogenous coronaviruses or other pathogens, the evidence suggests that excessive inflammation, oxidation, and an exaggerated immune response very likely contribute to COVID-19 pathology. This leads to a cytokine storm and subsequent progression to acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) and often death. Melatonin, a well-known anti-inflammatory and anti-oxidative molecule, is protective against ALI/ARDS caused by viral and other pathogens. Melatonin is effective in critical care patients by reducing vessel permeability, anxiety, sedation use, and improving sleeping quality, which might also be beneficial for better clinical outcomes for COVID-19 patients. Notably, melatonin has a high safety profile. There is significant data showing that melatonin limits virus-related diseases and would also likely be beneficial in COVID-19 patients. Additional experiments and clinical studies are required to confirm this speculation.
Melatonin as a potential adjuvant treatment for COVID-19. [Display omitted]