COVID-19: Melatonin as a potential adjuvant treatment

Life Sci. 2020 Jun 1;250:117583. doi: 10.1016/j.lfs.2020.117583. Epub 2020 Mar 23.

Abstract

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.

Publication types

  • Review

MeSH terms

  • Acute Lung Injury / virology
  • Adjuvants, Immunologic / therapeutic use*
  • Anti-Inflammatory Agents / therapeutic use
  • Antioxidants / therapeutic use
  • Betacoronavirus
  • Coronavirus Infections / drug therapy*
  • Coronavirus Infections / immunology*
  • Cytokines / immunology
  • Humans
  • Immunomodulation
  • Inflammation / drug therapy
  • Melatonin / therapeutic use*
  • Pandemics
  • Pneumonia, Viral / drug therapy*
  • Pneumonia, Viral / immunology*
  • Respiratory Distress Syndrome, Adult / virology

Substances

  • Adjuvants, Immunologic
  • Anti-Inflammatory Agents
  • Antioxidants
  • Cytokines
  • Melatonin

Supplementary concepts

  • COVID-19
  • COVID-19 drug treatment
  • severe acute respiratory syndrome coronavirus 2