Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jun 1;250:117583.
doi: 10.1016/j.lfs.2020.117583. Epub 2020 Mar 23.

COVID-19: Melatonin as a Potential Adjuvant Treatment

Free PMC article

COVID-19: Melatonin as a Potential Adjuvant Treatment

Rui Zhang et al. Life Sci. .
Free PMC article


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.

Keywords: COVID-19; Cytokines; Immunomodulation; Melatonin; Oxidation-reduction; SARS-CoV-2.

Conflict of interest statement

Declaration of competing interest The authors declare that there are no conflicts of interest.


Unlabelled Image
Fig. 1
Fig. 1
Pathogenesis of COVID-19 and potential adjuvant use of melatonin. We postulated that lungs infected by SARS-CoV-2, and a suppressed immune response, elevated inflammation and excessive oxidation stress proceed unabated, this results in the activation of the cytokine storm. ALI/ARDS may ensue, accompanied by a series of complications, the outcomes of which vary according to the severity of the disease. Melatonin may play a role of adjuvant medication in the regulation of immune system, inflammation and oxidation stress, and provide support for patients with ALI/ARDS and related complications. ALI: Acute lung injury; ARDS: Acute respiratory distress syndrome.

Similar articles

See all similar articles

Cited by 6 articles

See all "Cited by" articles


    1. Cui J., Li F., Shi Z.-L. Origin and evolution of pathogenic coronaviruses. Nat. Rev. Microbiol. 2019;17:181–192. doi: 10.1038/s41579-018-0118-9. - DOI - PMC - PubMed
    1. Huang C., Wang Y., Li X., Ren L., Zhao J., Hu Y., Zhang L., Fan G., Xu J., Gu X., Cheng Z., Yu T., Xia J., Wei Y., Wu W., Xie X., Yin W., Li H., Liu M., Xiao Y., Gao H., Guo L., Xie J., Wang G., Jiang R., Gao Z., Jin Q., Wang J., Cao B. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet (London, England) 2020;395:497–506. doi: 10.1016/S0140-6736(20)30183-5. - DOI - PMC - PubMed
    1. Reiter R.J., Ma Q., Sharma R. Treatment of Ebola and other infectious diseases: melatonin “goes viral”. Melatonin Res. 2020;3:43–57. doi: 10.32794/mr11250047. - DOI
    1. Wu X., Ji H., Wang Y., Gu C., Gu W., Hu L., Zhu L. Melatonin alleviates radiation-induced lung injury via regulation of miR-30e/NLRP3 axis. Oxidative Med. Cell. Longev. 2019;2019:4087298. doi: 10.1155/2019/4087298. - DOI - PMC - PubMed
    1. Yip H.-K., Chang Y.-C., Wallace C.G., Chang L.-T., Tsai T.-H., Chen Y.-L., Chang H.-W., Leu S., Zhen Y.-Y., Tsai C.-Y., Yeh K.-H., Sun C.-K., Yen C.-H. Melatonin treatment improves adipose-derived mesenchymal stem cell therapy for acute lung ischemia-reperfusion injury. J. Pineal Res. 2013;54:207–221. doi: 10.1111/jpi.12020. - DOI - PubMed

MeSH terms

Supplementary concepts