COVID-19: Melatonin as a potential adjuvant treatment
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Coronaviruses (CoVs) are RNA viruses infecting both humans and animals; this infection involves the respiratory, gastrointestinal and central nervous systems. Severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) are infectious and lethal and have caused thousands of deaths in the past two decades. The recent outbreak was discovered in Wuhan, China; this highly contagious disease has spread throughout China and other countries. Although antiviral therapy, corticosteroid therapy, and mechanical respiratory support have been applied, there is a lack of a specific treatment for COVID-19.

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.

Source: https://www.sciencedirect.com/science/article/pii/S0024320520303313
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