The Coronavirus Disease 2019 (COVID-19): Key Emphasis on Melatonin Safety and Therapeutic Efficacy

Abstract

Viral infections constitute a tectonic convulsion in the normophysiology of the hosts. The current coronavirus disease 2019 (COVID-19) pandemic is not an exception, and therefore the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, like any other invading microbe, enacts a generalized immune response once the virus contacts the body. Melatonin is a systemic dealer that does not overlook any homeostasis disturbance, which consequently brings into play its cooperative triad, antioxidant, anti-inflammatory, and immune-stimulant backbone, to stop the infective cycle of SARS-CoV-2 or any other endogenous or exogenous threat. In COVID-19, the corporal propagation of SARS-CoV-2 involves an exacerbated oxidative activity and therefore the overproduction of great amounts of reactive oxygen and nitrogen species (RONS). The endorsement of melatonin as a possible protective agent against the current pandemic is indirectly supported by its widely demonstrated beneficial role in preclinical and clinical studies of other respiratory diseases. In addition, focusing the therapeutic action on strengthening the host protection responses in critical phases of the infective cycle makes it likely that multi-tasking melatonin will provide multi-protection, maintaining its efficacy against the virus variants that are already emerging and will emerge as long as SARS-CoV-2 continues to circulate among us.

Hospitalized COVID-19 Patients Were Five Times More Likely to Suffer From Total Sleep Deprivation Compared to Non-COVID-19 Patients; an Observational Comparative Study

“…Since melatonin has anti-inflammatory and immunomodulatory effects, a decrease in night-time melatonin levels is thought to increase the susceptibility for the SARS-CoV-2 virus. Melatonin has even been suggested as an adjunctive therapy in patients with COVID-19 (Ramos et al, 2021). The secretion of melatonin is synchronized with the rhythm of the immune system.…”

“…Interventions should focus on environmental factors on the ward (e.g., reducing noise of hospital staff, other patients and medical devices were possible, and maintaining a healthy circadian rhythm), psychological treatment (e.g., emotional support) and symptom relief (e.g., alleviating breathing difficulties, adequate medication). Given the possible beneficial effects of melatonin during a COVID-19 infection and the minor side effects if used correctly, administration of melatonin could be considered (Corrao et al, 2021;Ramos et al, 2021).…”

Sleep Deprivation, Immune Suppression and SARS-CoV-2 Infection

“…The circadian rhythm is strongly dependent on the release of this hormone with anti-inflammatory and immunomodulatory effects and the secretion of melatonin is synchronized with the rhythm of the immune system. For this reason, a disrupted circadian rhythm caused by poor sleep may decrease night-time melatonin levels increasing the susceptibility for SARS-CoV-2 infection [ 103 ]. Recent research showed a potential therapeutic role of melatonin and melatonergic drugs on K18-hACE2 mice infected with SARS-CoV-2 [ 104 ].…”

Efficacy, Safety, and Drug–Drug Interactions for Insomnia Therapy in COVID-19 Patients

“…Melatonin has antiinflammatory and immunomodulatory effects. 38 There is no effect on the long-term use of melatonin; the side effects increase with increasing the dose. 39 Another drug in the melatonin group is Ramelteon.…”