Melatonin is not virucidal but it has indirect antiviral actions due to its anti-inflammatory, anti-oxidation and immune enhancing features. There are situations in which melatonin suppresses the features of viral infections. With the anti-inflammatory effect it protects the lung tissue from lung injury. The melatonin seems to help control the inflammation and oxidation in coronavirus infected subjects. The melatonin improves the proliferation and maturation of natural killer cells. It may also ameliorate the septic shock via the NLRP3 pathway.
Melatonin also helps sleep during a high anxiety provoking time!
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Fig. 1. Pathogenesis of COVID-19 and potential adjuvant use of melatonin. We postulated that lungs infected by SARS-CoV-2, and a suppressed immune response, elevated inflammation and excessive oxidation stress proceed unabated, this results in the activation of the cytokine storm. ALI/ARDS may ensue, accompanied by a series of complications, the outcomes of which vary according to the severity of the disease. Melatonin may play a role of adjuvant medication in the regulation of immune system, inflammation and oxidation stress, and provide support for patients with ALI/ARDS and related complications. ALI: Acute lung injury; ARDS: Acute respiratory distress syndrome.
The possible beneficial effects of melatonin as adjuvant use in COVID-19 in anti-inflammation, anti-oxidation, immune response regulation has been repeatedly demonstrated in respiratory disorder models induced by infections and associated complications. Melatonin has a high safety profile. Although the direct evidence of melatonin application in COVID-19 is unclear, both its use in experimental animal models and in studies on humans has continuously documented its efficacy and safety and its use by COVID-19 patients predictably would be highly beneficial.