The Use of Melatonin in Patients With COVID-19


The COVID-19 pandemic has infected hundreds of thousands and killed tens of thousands of individuals worldwide. Unfortunately, time is not a luxury that this crisis has. The high mortality is caused by the uncontrolled innate immune response and destructive inflammation. Melatonin, a well-known chronobiotic, is also a promising adjunctive drug for viral infections due to its anti-inflammatory, antiapoptotic, immunomodulatory, and powerful antioxidant properties. In addition, melatonin promotes both cell-mediated and humoral immunity. 1

It motivates the synthesis of progenitor cells for macrophages and granulocytes, NK cells, and T-helper cells, specifically CD4+ cells. In addition, melatonin supplementation induces the production of family cytokines with pleiotropic functions, including IL-2, IL-6, and IL- 12, and reduces CD8+ cells generation. Therefore, under the current critical conditions, using large doses of melatonin alone or currently-recommended drugs, e.g., hydroxychloroquine/chloroquine, to resist COVID-19 infection would seem judicious. 2

Use of Melatonin for Treatment of COVID-19 in the Population:

The cytokine storm magnifies the danger signal of the virus invasion but also leads to destructive inflammation and host cell damage. In addition, the cytokine storm leads to acute cardiac injury, acute respiratory distress syndrome, and infection, leading to generalized sepsis and multisystem failure, which may lead to death. Thus, preventing the cytokine storm may be essential for treating COVID-19-infected patients. Since there is a lack of effective therapies and immunological treatments may be insufficient, melatonin, owing to its multiple actions, may have beneficial effects in preventing or attenuating the cytokine storm and reducing morbidity and mortality from this disease.1

In elderly patients with medical comorbidities, treatment with melatonin is beneficial, as it strengthens the immune response. We suggest a daily dose of ~3 mg to a maximum of 10 mg, 30–60 min before bedtime, to better simulate melatonin's normal physiological circadian rhythm. Furthermore, local health workers may benefit people at high risk of contracting COVID-19 infection, where preventive treatment with melatonin would favor maximizing the immune response, along with anti-inflammatory and antioxidant effects.

According to knowledge-based evidence, a good medical practice requires the physician to use legally available medications. If physicians use a product for an indication that is not currently approved, they must base its use on sound scientific reasons and sound medical evidence. Melatonin should be considered a treatment option for this deadly disease. Melatonin is clinically helpful in sepsis, where the clinical features parallel those of COVID-19 viral infection; moreover, melatonin has been demonstrated to relieve many of the symptoms of other viral infections. Given the current worldwide situation and in consideration of evidence-based medicine, the efficacy of melatonin and its high pharmacological safety profile supports its use in the treatment of infectious diseases, such as COVID-19. Melatonin has an extensive safety margin without serious adverse effects.


References

1. https://www.frontiersin.org/articles/10.3389/fmed.2020.00226/full
2. https://www.sciencedirect.com/science/article/pii/S0168170220310157


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Disclaimer: These statements have not been evaluated by the Food and Drug Administration. The contents of this website are based upon the views of Dr. Walker and his experience. This product is not intended as medical advice nor to diagnose, treat, cure or prevent any disease. The information is likewise not to replace the advice of a qualified health care provider. The information provided herein is intended as a sharing of general knowledge only and is not intended to be, nor is it, medical advice or a substitute for medical advice. That being said, please consult your healthcare provider before using supplements or providing supplements to children under the age of 18. If you have or suspect you have, a specific medical condition or disease, please consult your healthcare provider.

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