Articles

Coronaviruses (CoVs) are a broad family of potentially serious RNA viruses that are now causing an outbreak of respiratory disease known as CoV disease 2019 (COVID-19). Melatonin is a pineal hormone that is predominantly produced and released at night from the amino acid tryptophan. Melatonin and its metabolites are also important in immunomodulation, and they have antioxidative properties due to their capacity to scavenge reactive oxygen species both directly and indirectly. COVID-19 leads to changes of altered consciousness levels in about 15% of hospitalized patients, starting from somnolence to disorientation, delirium, stupor, and coma. Melatonin can decrease the molecules that cause delirium in the elderly and central respiratory depression, such as benzodiazepines and antipsychotics. Melatonin may help alleviate infection-induced acute respiratory distress as well as its diverse effects, which include anti-inflammatory, antioxidative, and immune-enhancing properties. Its supplemental dose may be able to prevent SARS-COV-2 infections by reversing aerobic glycolysis via suppression of both HIF-1 and mTOR, allowing pyruvate dehydrogenase complex activity to be suppressed and acetyl-coenzyme A to be produced. When mitochondrion-produced and parenteral melatonin are combined, the cytokine storm is reduced, and COVID-19 infection-induced damage is alleviated. In conclusion, melatonin could have an important role in the management of COVID-19.