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A mid‑pandemic night's dream: Melatonin, from harbinger of anti‑inflammation to mitochondrial savior in acute and long COVID‑19 (Review)

Lempesis et al., International Journal of Molecular Medicine, doi:10.3892/ijmm.2024.5352
Jan 2024  
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Melatonin for COVID-19
10th treatment shown to reduce risk in December 2020
*, now known with p = 0.0000002 from 18 studies.
Lower risk for mortality, ventilation, and recovery.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
3,800+ studies for 60+ treatments.
Review of the therapeutic potential of melatonin for COVID-19 and long COVID. Authors provide an extensive review of melatonin's role in health and disease, covering antioxidant, anti-inflammatory, antiviral, and mitochondria-protective properties. Authors detail the pathophysiology of acute COVID-19 and the potential long-term effects like mitochondrial dysfunction. Multiple mechanisms are proposed for how melatonin could alleviate acute symptoms and long-term organ damage from COVID-19 through targeting oxidative stress, inflammation, immune system regulation, viral entry, and supporting mitochondrial health.
Reviews covering melatonin for COVID-19 include Alomari, Behl, Camp, Castle, Charaa, Cross, DiNicolantonio, Hosseinzadeh, Langen, Lempesis, Loh, Ramos, Reiter, Reiter (B), Shneider, Tan, Zhang.
Lempesis et al., 26 Jan 2024, multiple countries, peer-reviewed, 4 authors. Contact:
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A mid‑pandemic night's dream: Melatonin, from harbinger of anti‑inflammation to mitochondrial savior in acute and long COVID‑19 (Review)
Ioannis G Lempesis, Vasiliki Epameinondas Georgakopoulou, Russel J Reiter, Demetrios A Spandidos
International Journal of Molecular Medicine, doi:10.3892/ijmm.2024.5352
Coronavirus disease 2019 (COVID-19) , a systemic illness caused by severe acute respiratory distress syndrome 2 (SARS-CoV-2), has triggered a worldwide pandemic with symptoms ranging from asymptomatic to chronic, affecting practically every organ. Melatonin, an ancient antioxidant found in all living organisms, has been suggested as a safe and effective therapeutic option for the treatment of SARS-CoV-2 infection due to its good safety characteristics and broad-spectrum antiviral medication properties. Melatonin is essential in various metabolic pathways and governs physiological processes, such as the sleep-wake cycle and circadian rhythms. It exhibits oncostatic, anti-inflammatory, antioxidant and anti-aging properties, exhibiting promise for use in the treatment of numerous disorders, including COVID-19. The preventive and therapeutic effects of melatonin have been widely explored in a number of conditions and have been well-established in experimental ischemia/reperfusion investigations, particularly in coronary heart disease and stroke. Clinical research evaluating the use of melatonin in COVID-19 has shown various improved outcomes, including reduced hospitalization durations; however, the trials are small. Melatonin can alleviate mitochondrial dysfunction in COVID-19, improve immune cell function and provide antioxidant properties. However, its therapeutic potential remains underexplored due to funding limitations and thus further investigations are required.
Authors' contributions DAS and VEG conceptualized the study. IGL, VEG, RJR and DAS made a substantial contribution to the interpretation and analysis of data from the literature to be included in the review, and wrote and prepared the draft of the manuscript. DAS and RJR analyzed the data and provided critical revisions. All authors contributed to manuscript revision, and have read and approved the final version of the manuscript. Data authentication is not applicable. Ethics approval and consent to participate Not applicable. Patient consent for publication Not applicable. Competing interests DAS is the Editor-in-Chief for the journal, but had no personal involvement in the reviewing process, or any influence in terms of adjudicating on the final decision, for this article. The other authors declare that they have no competing interests.
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