Abstract
The coronavirus, COVID-19, has infected hundreds of thousands and killed tens of thousands of individuals worldwide. This highly infectious condition continues to ravage the world population and has yet to reach it peak infective rate in some countries. Many conventional drugs including hydroxychloroquine/chloroquine, lopinavir, remdesivir, etc., have been repurposed as treatments for this often deadly disease, but there is no specifically-designed effective drug available; also, the drugs mentioned have significant side effects and their efficacy is unknown. New drugs and vaccines are being designed as COVID-19 treatment, but their development and testing will require months to years. Time is not a luxury that this crisis has. Thus, there is a serious unmet need for the identification of currently-available and safe molecules which can be used to slow or treat COVID-19 disease. Here, we suggest melatonin be given consideration for prophylactic use or treatment alone or in combination with other drugs. Melatonin's multiple actions as an anti-inflammatory, anti-oxidant, and anti-viral (against other viruses) make it a reasonable choice for use. Melatonin is readily available, can be easily synthesized in large quantities, is inexpensive, has a very high safety profile and can be easily self-administered. Melatonin is endogenously-produced molecule in small amounts with its production diminishing with increased age. Under the current critical conditions, large doses of melatonin alone or in combination with currently-recommended drugs, e.g., hydroxychloroquine/chloroquine, to resist COVID-19 infection would seem judicious.
Highlights
In the past 20 years, two coronavirus epidemics that originated in China caused large-scale pandemics that involved over 20 countries leading to ∼8,000 cases and 800 deaths
Since the clinical data is very limited, we propose the use of melatonin in patients with COVID-19 to reduce morbidity and mortality
As there is no time or clinical trials to test the efficacy of melatonin at different concentrations, we suggest the use of melatonin (100 or 400 mg per day) as an adjunct, especially if no efficient direct anti-viral treatment is available (Figure 2)
Summary
In the past 20 years, two coronavirus epidemics that originated in China caused large-scale pandemics that involved over 20 countries leading to ∼8,000 cases and 800 deaths. In 2002 the Middle East respiratory syndrome coronavirus produced 2,500 cases with infection and caused 800 deaths. The cardinal symptoms of COVID-19 are cough, fever, and shortness of breath These symptoms appear 2–14 days after infection [4, 5]. There is no specific treatment for COVID19, so drugs need to be developed or reused to end the pandemic. The medical profession has quickly realized that there is no cure for this disease and vaccines will not be available for several months. This leaves a large unmet need for safe and effective treatments for COVID-19-infected patients. Since the clinical data is very limited, we propose the use of melatonin in patients with COVID-19 to reduce morbidity and mortality
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