A Review of the Potential Effects of Melatonin in Compromised Mitochondrial Redox Activities in Elderly Patients With COVID-19

Abstract

Melatonin, an endogenous indoleamine, is an antioxidant and anti-inflammatory molecule widely distributed in the body. It efficiently regulates pro-inflammatory and anti-inflammatory cytokines under various pathophysiological conditions. The melatonin rhythm, which is strongly associated with oxidative lesions and mitochondrial dysfunction, is also observed during the biological process of aging. Melatonin levels decline considerably with age and are related to numerous age-related illnesses. The signs of aging, including immune aging, increased basal inflammation, mitochondrial dysfunction, significant telomeric abrasion, and disrupted autophagy, contribute to the increased severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. These characteristics can worsen the pathophysiological response of the elderly to SARS-CoV-2 and pose an additional risk of accelerating biological aging even after recovery. This review explains that the death rate of coronavirus disease (COVID-19) increases with chronic diseases and age, and the decline in melatonin levels, which is closely related to the mitochondrial dysfunction in the patient, affects the virus-related death rate. Further, melatonin can enhance mitochondrial function and limit virus-related diseases. Hence, melatonin supplementation in older people may be beneficial for the treatment of COVID-19.

Association of sleep quality with fatigue in post Covid-19 patients in an Indian population

“…Melatonin has demonstrated a protective effect in limiting the intensity of the COVID-19 infection. 24 Melatonin and its metabolites reduce the levels of inflammatory cytokine interleukin 6 in vitro. 25 Therapeutic administration of melatonin demonstrated satisfactory outcomes in COVID-19 infection with a reduction of severity of symptoms.…”

“…Melatonin release can be inhibited by viruses. Melatonin has demonstrated a protective effect in limiting the intensity of the COVID-19 infection 24 . Melatonin and its metabolites reduce the levels of inflammatory cytokine interleukin 6 in vitro 25 .…”

The Concomitant Use o f Melatonin and Bebtelovimab as a Treatment Strategy for Omicron and Future Variants of Concern

“…COVID-19 causes cytokine storm syndrome and acute respiratory distress syndrome (ARDS) due to the uncontrollable production of inflammatory mediators [46]. Melatonin is thought to lessen this cytokine storm by boosting the activity of natural killer cells while lowering reactive oxygen species, the interferon-gamma response, and T-helper cells [47]. Melatonin, like corticosteroids, lowers NF-ĸB activity to reduce the hyperinflammatory response to some respiratory infections [40].…”

“…Viral infections produce reactive oxygen species. Old age and significant co-morbidities such as diabetes, cancer, and heart issues may make the immune system more vulnerable to SARS-CoV-2 infection [47]. Affected immune responses, the pathogenicity of novel viral variants, and unstable and uncontrolled generation of ROS related to cytokine storms are all factors in the development of COVID-19 infection [50].…”

“…Furthermore, it has been observed that when melatonin is used with other medications in the treatment of COVID-19, it boosts the effectiveness of these treatments while decreasing the possibility of adverse effects [1,48]. Melatonin also dramatically reduced circulating cytokine levels in other disorders with high levels of inflammation besides COVID-19 [47,48]. In light of all of this evidence, it has been demonstrated that melatonin is safe for short-term usage, even at high dosages [48].…”