Melatonin as an Add-On Treatment of COVID-19 Infection: Current Status

This brief review was written to provide a perspective on the flurry of reports suggesting that melatonin can be an important add-on therapy for COVID-19. Despite the passage of more than 60 years since its discovery and much evidence representing the contrary, there has been great reluctance to con...

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Main Authors: Gregory M. Brown, Seithikurippu R. Pandi-Perumal, Harold Pupko, James L. Kennedy, Daniel P. Cardinali
Format: Article
Language:English
Published: MDPI AG 2021-09-01
Series:Diseases
Subjects:
Online Access:https://www.mdpi.com/2079-9721/9/3/64
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author Gregory M. Brown
Seithikurippu R. Pandi-Perumal
Harold Pupko
James L. Kennedy
Daniel P. Cardinali
author_facet Gregory M. Brown
Seithikurippu R. Pandi-Perumal
Harold Pupko
James L. Kennedy
Daniel P. Cardinali
author_sort Gregory M. Brown
collection DOAJ
description This brief review was written to provide a perspective on the flurry of reports suggesting that melatonin can be an important add-on therapy for COVID-19. Despite the passage of more than 60 years since its discovery and much evidence representing the contrary, there has been great reluctance to conceive melatonin as anything other than a hormone. Many other body chemicals are known to have multiple roles. Melatonin was first shown to be a hormone derived from the pineal gland, to be actively synthesized there only at night, and to act on targets directly or via the G-protein-coupled receptors (GPCRs) superfamily. It is of note that over 40 years ago, it was also established that melatonin is present, synthesized locally, and acts within the gastrointestinal tract. A wider distribution was then found, including the retina and multiple body tissues. In addition, melatonin is now known to have non-hormonal actions, acting as a free radical scavenger, an antioxidant, and as modulating immunity, dampening down innate tissue responses to invaders while boosting the production of antibodies against them. These actions make it a potentially excellent weapon against infection by the SARS-CoV-2 virus. Early published results support that thesis. Recently, a randomized controlled study reported that low doses of melatonin significantly improved symptoms in hospitalized COVID-19 patients, leading to more rapid discharge with no side effects, while significantly decreasing levels of CRP, proinflammatory cytokines, and modulating dysregulated genes governing cellular and humoral immunity. It is now critical that these trials be repeated, with dose-response studies conducted and safety proven. Numerous randomized controlled trials are ongoing, which should complete those objectives while also allowing for a more thorough evaluation of the mechanisms of action and possible applications to other severe diseases.
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spelling doaj.art-fcccff762f15490fab96875644c8f9d82023-11-22T12:41:52ZengMDPI AGDiseases2079-97212021-09-01936410.3390/diseases9030064Melatonin as an Add-On Treatment of COVID-19 Infection: Current StatusGregory M. Brown0Seithikurippu R. Pandi-Perumal1Harold Pupko2James L. Kennedy3Daniel P. Cardinali4Centre for Addiction and Mental Health, Molecular Brain Sciences, Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, CanadaSomnogen Canada Inc., Toronto, ON M6H 1C5, CanadaPrimary Care Mental Health Physician, Bathurst St., Toronto, ON M3H 3S3, CanadaCentre for Addiction and Mental Health, Molecular Brain Sciences, Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, CanadaFaculty of Medical Sciences, Pontificia Universidad Católica Argentina, Buenos Aires 1007, ArgentinaThis brief review was written to provide a perspective on the flurry of reports suggesting that melatonin can be an important add-on therapy for COVID-19. Despite the passage of more than 60 years since its discovery and much evidence representing the contrary, there has been great reluctance to conceive melatonin as anything other than a hormone. Many other body chemicals are known to have multiple roles. Melatonin was first shown to be a hormone derived from the pineal gland, to be actively synthesized there only at night, and to act on targets directly or via the G-protein-coupled receptors (GPCRs) superfamily. It is of note that over 40 years ago, it was also established that melatonin is present, synthesized locally, and acts within the gastrointestinal tract. A wider distribution was then found, including the retina and multiple body tissues. In addition, melatonin is now known to have non-hormonal actions, acting as a free radical scavenger, an antioxidant, and as modulating immunity, dampening down innate tissue responses to invaders while boosting the production of antibodies against them. These actions make it a potentially excellent weapon against infection by the SARS-CoV-2 virus. Early published results support that thesis. Recently, a randomized controlled study reported that low doses of melatonin significantly improved symptoms in hospitalized COVID-19 patients, leading to more rapid discharge with no side effects, while significantly decreasing levels of CRP, proinflammatory cytokines, and modulating dysregulated genes governing cellular and humoral immunity. It is now critical that these trials be repeated, with dose-response studies conducted and safety proven. Numerous randomized controlled trials are ongoing, which should complete those objectives while also allowing for a more thorough evaluation of the mechanisms of action and possible applications to other severe diseases.https://www.mdpi.com/2079-9721/9/3/64melatoninCOVID-19RCTimmunitycytokinesmitochondria
spellingShingle Gregory M. Brown
Seithikurippu R. Pandi-Perumal
Harold Pupko
James L. Kennedy
Daniel P. Cardinali
Melatonin as an Add-On Treatment of COVID-19 Infection: Current Status
Diseases
melatonin
COVID-19
RCT
immunity
cytokines
mitochondria
title Melatonin as an Add-On Treatment of COVID-19 Infection: Current Status
title_full Melatonin as an Add-On Treatment of COVID-19 Infection: Current Status
title_fullStr Melatonin as an Add-On Treatment of COVID-19 Infection: Current Status
title_full_unstemmed Melatonin as an Add-On Treatment of COVID-19 Infection: Current Status
title_short Melatonin as an Add-On Treatment of COVID-19 Infection: Current Status
title_sort melatonin as an add on treatment of covid 19 infection current status
topic melatonin
COVID-19
RCT
immunity
cytokines
mitochondria
url https://www.mdpi.com/2079-9721/9/3/64
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