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1.
Vertex ; XXXIII(155): 13-24, 2022 Mar.
Article in Spanish | MEDLINE | ID: covidwho-1791217

ABSTRACT

INTRODUCTION: Melatonin is a safe medication with multiple uses in sleep medicine for the treatment of circadian rhythm disorders, insomnia, and REM sleep behavior disorder. In view that melatonin has been recommended as an adjuvant treatment in COVID-19 pandemic mainly due to its anti-inflammatory properties, the objective of the present study was to evaluate the history of COVID-19 infection and the requirement of hospitalization in a group of adult patients previously treated with melatonin for various sleep disorders. MATERIAL AND METHODS: This is a retrospective cross-sectional study of data from a closed population of 110 adult patients at a University Hospital treated with melatonin for various sleep disorders, analyzed until the onset of COVID-19 pandemic. Demographic and melatonin-related variables (dose, treatment time) were analyzed and were reevaluated during the pandemic period, by scheduled tele-consultation regarding diagnosis, hospitalization requirements, variables related to COVID-19 infection prior to specific vaccination. Categorical variables were described as relative and absolute frequencies. RESULTS: N = 110 patients. Age range = 40- 96 years (mean = 71 years ± 9.9), older adults > 65 years: N =87 (79,1%). COVID-19 infection was recorded in 15 patients (13.5%) requiring hospitalization in 5 of those infected, only one of them with severe pneumonia. There were no deaths due to COVID-19. There were no differences between infected vs. uninfected in age (p = 0.74), body mass index (p = 0.65) or melatonin dose (p = 0.10).The melatonin dose range was 3-150 mg / day (mean = 46.33 ± 34.1), older adults receiving a mean dose of 50,3 ± 35,6.The 75.5% of the patients were treated for at least 12 months with melatonin. CONCLUSION: We found that 13.5% of patients previously treated with melatonin for various sleep disorders were infected by COVID-19, requiring hospitalization with subsequent medical discharge one third of them. According to national records the lethality rate in older adults in August 2020 was 10.5%. No patient treated with melatonin died for this cause in this sample. We did not find statistically significant differences in terms of indicated melatonin dose, age or body mass index, when comparing those infected with those not infected. The patients in general were mostly older adults, treated with a mean dose greater than 40 mg / day of melatonin for various sleep disorders, mainly for complaints of insomnia, for more than 12 months. The results are consistent with a possible preventive effect of melatonin in the COVID-19 pandemic.


Subject(s)
COVID-19 , Melatonin , Sleep Initiation and Maintenance Disorders , Sleep Wake Disorders , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , Cross-Sectional Studies , Humans , Melatonin/therapeutic use , Middle Aged , Pandemics , Retrospective Studies , SARS-CoV-2 , Sleep Initiation and Maintenance Disorders/drug therapy , Sleep Wake Disorders/drug therapy , Sleep Wake Disorders/epidemiology
2.
J Med Virol ; 94(5): 2102-2107, 2022 05.
Article in English | MEDLINE | ID: covidwho-1777583

ABSTRACT

This study investigated the effect of melatonin on clinical outcomes in patients with coronavirus disease 2019 (COVID-19). We searched PubMed, the Web of Science, the Cochrane Library, Ovid MEDLINE, and Clinicaltrials.gov for randomized controlled trials (RCTs) published before September 11, 2021. Only RCTs that compared the clinical efficacy of melatonin with a placebo in the treatment of patients with COVID-19 were included. The primary outcome measure was the clinical recovery rate. We included three RCTs in this meta-analysis. Melatonin 3 mg three times daily was administered in one RCT, and 3 or 6 mg daily before bedtime in the other two trials. Treatment duration was 14 days in two RCTs and 7 days in one trial. The clinical recovery rates were 94.2% (81/86) and 82.4% (70/85) in the melatonin and control groups, respectively. Overall, patients receiving melatonin had a higher clinical recovery rate than did the controls (odds ratio [OR]: 3.67; 95% CI: 1.21-11.12; I2 = 0%, p = 0.02). The risk of intensive care unit admission was numerically lower in the melatonin group than in the control group (8.3% [6/72] vs. 17.6% [12/68], OR: 0.45; 95% CI: 0.16-1.25; I2 = 0%, p = 0.13), and the risk of mortality was numerically lower in the melatonin group than in the control group (1.4% [1/72] vs. 4.4% [3/68], OR: 0.32; 95% CI: 0.03-3.18; I2 = 0%, p = 0.33). In conclusion, melatonin may help improve the clinical outcomes of patients with COVID-19.


Subject(s)
COVID-19 , Melatonin , COVID-19/drug therapy , Humans , Melatonin/therapeutic use , Randomized Controlled Trials as Topic , Respiration, Artificial , SARS-CoV-2
4.
Cell Mol Life Sci ; 79(3): 143, 2022 Feb 20.
Article in English | MEDLINE | ID: covidwho-1701908

ABSTRACT

Numerous pharmaceutical drugs have been repurposed for use as treatments for COVID-19 disease. These drugs have not consistently demonstrated high efficacy in preventing or treating this serious condition and all have side effects to differing degrees. We encourage the continued consideration of the use of the antioxidant and anti-inflammatory agent, melatonin, as a countermeasure to a SARS-CoV-2 infection. More than 140 scientific publications have identified melatonin as a likely useful agent to treat this disease. Moreover, the publications cited provide the rationale for the use of melatonin as a prophylactic agent against this condition. Melatonin has pan-antiviral effects and it diminishes the severity of viral infections and reduces the death of animals infected with numerous different viruses, including three different coronaviruses. Network analyses, which compared drugs used to treat SARS-CoV-2 in humans, also predicted that melatonin would be the most effective agent for preventing/treating COVID-19. Finally, when seriously infected COVID-19 patients were treated with melatonin, either alone or in combination with other medications, these treatments reduced the severity of infection, lowered the death rate, and shortened the duration of hospitalization. Melatonin's ability to arrest SARS-CoV-2 infections may reduce health care exhaustion by limiting the need for hospitalization. Importantly, melatonin has a high safety profile over a wide range of doses and lacks significant toxicity. Some molecular processes by which melatonin resists a SARS-CoV-2 infection are summarized. The authors believe that all available, potentially beneficial drugs, including melatonin, that lack toxicity should be used in pandemics such as that caused by SARS-CoV-2.


Subject(s)
Antioxidants/therapeutic use , Antiviral Agents/therapeutic use , COVID-19/drug therapy , Melatonin/therapeutic use , SARS-CoV-2/drug effects , COVID-19/virology , Humans
5.
Life Sci ; 294: 120368, 2022 Apr 01.
Article in English | MEDLINE | ID: covidwho-1654900

ABSTRACT

The fear of SARS-CoV-2 infection is due to its high mortality related to seasonal flu. To date, few medicines have been developed to significantly reduce the mortality of the severe COVID-19 patients, especially those requiring tracheal intubation. The severity and mortality of SARS-CoV-2 infection not only depend on the viral virulence, but are primarily determined by the cytokine storm and the destructive inflammation driven by the host immune reaction. Thus, to target the host immune response might be a better strategy to combat this pandemic. Melatonin is a molecule with multiple activities on a virus infection. These include that it downregulates the overreaction of innate immune response to suppress inflammation, promotes the adaptive immune reaction to enhance antibody formation, inhibits the entrance of the virus into the cell as well as limits its replication. These render it a potentially excellent candidate for treatment of the severe COVID-19 cases. Several clinical trials have confirmed that melatonin when added to the conventional therapy significantly reduces the mortality of the severe COVID-19 patients. The cost of melatonin is a small fraction of those medications approved by FDA for emergency use to treat COVID-19. Because of its self-administered, low cost and high safety margin, melatonin could be made available to every country in the world at an affordable cost. We recommend melatonin be used to treat severe COVID-19 patients with the intent of reducing mortality. If successful, it would make the SARS-CoV-2 pandemic less fearful and help to return life back to normalcy.


Subject(s)
COVID-19/drug therapy , Melatonin/therapeutic use , SARS-CoV-2 , Anti-Inflammatory Agents , Antioxidants , COVID-19/immunology , COVID-19/mortality , Cytokine Release Syndrome/drug therapy , Humans , Immunity, Innate/drug effects , SARS-CoV-2/drug effects , SARS-CoV-2/physiology , Virus Replication/drug effects
6.
Med Sci (Paris) ; 38(1): 89-95, 2022 Jan.
Article in French | MEDLINE | ID: covidwho-1642032

ABSTRACT

Melatonin is a naturally occurring molecule derived from tryptophan. Melatonin is a key player in relaying the circadian rhythm between our environment and our body. It has also a key role in rhythming the seasons (more production during long nights and less during short ones) as well as in the reproduction cycles of the mammals. Melatonin is often and surprisingly presented as a molecule with multiple therapeutic properties that can fix (or help to fix) many health issues, such as diseases (cancer, ageing, virus-induced affections including COVID-19, etc…) or toxicological situations (metals, venoms, chemical such as adriamycin [doxorubicin], methotrexate or paclitaxel). The mechanistics behind those wonders is still missing and this is puzzling. In the present commentary, the main well-established biological properties are presented and briefly discussed with the aim of delineating the borders between facts and wishful thinking.


TITLE: Mélatonine - Petit précis à l'usage des trop enthousiastes. ABSTRACT: La mélatonine est une molécule naturelle dérivée du tryptophane. Son rôle est de servir de relai entre la rythmicité jour/nuit et notre corps. Elle sert donc de marqueur circadien : concentration haute pendant la nuit et basse pendant la journée. Elle sert aussi de marque saisonnière : plus les nuits sont longues et plus longuement elle est produite (et vice-versa), ce qui a un rôle primordial dans les cycles reproductifs des animaux. Mais elle est aussi affublée de multiples propriétés thérapeutiques concernant la plupart des maladies humaines, du cancer à la COVID-19 en passant par l'infection par le virus Ebola, ainsi que de capacités thérapeutiques vis-à-vis de multiples toxicités (métaux, venins, produits chimiques comme l'adriamycine [doxorubicine], le méthotrexate ou le paclitaxel). Alors que l'enthousiasme à propos de cette molécule est troublant, l'assise scientifique de ces descriptions est dans le meilleur des cas faible et dans la plupart des cas, inexistante. Dans ce commentaire, les données scientifiques bien établies liées à la mélatonine sont résumées et brièvement discutées, en tâchant de redessiner les limites entre ce qui est connu et bien établi et ce qui reste du domaine du fantasme.


Subject(s)
Circadian Rhythm/drug effects , Communication , Melatonin/pharmacology , Melatonin/physiology , Animals , COVID-19/drug therapy , Humans , Melatonin/therapeutic use , Reproducibility of Results , Seasons
8.
J Evid Based Integr Med ; 26: 2515690X211036875, 2021.
Article in English | MEDLINE | ID: covidwho-1495800

ABSTRACT

Worldwide, the turmoil of the SARS-CoV-2 (COVID-19) pandemic has generated a burst of research efforts in search of effective prevention and treatment modalities. Current recommendations on natural supplements arise from mostly anecdotal evidence in other viral infections and expert opinion, and many clinical trials are ongoing. Here the authors review the evidence and rationale for the use of natural supplements for prevention and treatment of COVID-19, including those with potential benefit and those with potential harms. Specifically, the authors review probiotics, dietary patterns, micronutrients, antioxidants, polyphenols, melatonin, and cannabinoids. Authors critically evaluated and summarized the biomedical literature published in peer-reviewed journals, preprint servers, and current guidelines recommended by expert scientific governing bodies. Ongoing and future trials registered on clinicaltrials.gov were also recorded, appraised, and considered in conjunction with the literature findings. In light of the controversial issues surrounding the manufacturing and marketing of natural supplements and limited scientific evidence available, the authors assessed the available data and present this review to equip clinicians with the necessary information regarding the evidence for and potential harms of usage to promote open discussions with patients who are considering dietary supplements to prevent and treat COVID-19.


Subject(s)
Antioxidants/therapeutic use , COVID-19/drug therapy , Dietary Supplements , Micronutrients/therapeutic use , Plant Extracts/therapeutic use , Antioxidants/pharmacology , Cannabinoids/pharmacology , Cannabinoids/therapeutic use , Humans , Melatonin/pharmacology , Melatonin/therapeutic use , Micronutrients/pharmacology , Niacinamide/pharmacology , Niacinamide/therapeutic use , Plant Extracts/pharmacology , Polyphenols/pharmacology , Polyphenols/therapeutic use , Probiotics/therapeutic use , SARS-CoV-2
9.
Med Gas Res ; 12(2): 41-43, 2022.
Article in English | MEDLINE | ID: covidwho-1481079

ABSTRACT

Cytokine storm in coronavirus disease 2019 (COVID-19) patients leads to acute lung injury, acute respiratory distress syndrome, multiorgan dysfunction, shock, and thrombosis thus contributing to significant morbidity and mortality. Several agents like steroids, ascorbic acid, vitamins (C, D, E), glutathione, N-acetylcysteine have been used and several studies are underway to identify its efficacy in addressing undesirable effects due to COVID-19 illness. Among several experimental modalities based on expert opinion and anecdotal data, melatonin is one molecule that appears promising. Owing to its anti-inflammatory, anti-oxidant, and immunomodulatory properties, melatonin can be an important agent used as a component of multimodal analgesia in COVID-19 patients, suspected patients, and patients with exposure to positive patients undergoing emergency or urgent surgeries. Further research is required to know the optimal time of initiation, dose, and duration of melatonin as an adjunct.


Subject(s)
Analgesia , COVID-19 , Melatonin , Cytokine Release Syndrome , Humans , Melatonin/therapeutic use , SARS-CoV-2
10.
Int J Infect Dis ; 114: 79-84, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1469871

ABSTRACT

OBJECTIVES: This study aimed to determine the effect of melatonin on thrombosis, sepsis, and mortality rate in adult patients with severe coronavirus infection (COVID-19). METHODS: This single-center, prospective, randomized clinical trial was conducted from 1 December 2020 to 1 June 2021 at Al-Shifaa hospital in Mosul, Iraq. There were 158 patients with severe COVID-19 included in the study: 82 in the melatonin group (who received 10 mg melatonin in addition to standard therapeutic care) and 76 in the control group (given standard therapeutic care only). Patients were chosen by a blocked randomization design. The physician then evaluated and recorded the incidence of thrombosis, sepsis, and mortality rate on days 5, 11, and 17 of symptoms. RESULTS: The intervention group consisted of 82 patients, while the control group consisted of 76 patients. In comparison to the control group, thrombosis and sepsis developed significantly less frequently (P < 0.05) in the melatonin group during the second week of infection, while mortality was significantly higher in the control group (P < 0.05). CONCLUSIONS: Adjuvant use of melatonin may help to reduce thrombosis, sepsis, and mortality in COVID-19 patients.


Subject(s)
COVID-19 , Melatonin , Sepsis , Thrombosis , Adult , Humans , Melatonin/therapeutic use , Prospective Studies , SARS-CoV-2 , Sepsis/drug therapy , Thrombosis/drug therapy , Treatment Outcome
11.
J Med Virol ; 94(1): 263-271, 2022 01.
Article in English | MEDLINE | ID: covidwho-1377590

ABSTRACT

This trial aims to evaluate the effectiveness of adding melatonin to the treatment protocol of hospitalized coronavirus disease 2019 (COVID-19) patients. This was an open-label, randomized controlled clinical trial in hospitalized COVID-19 patients. Patients were randomized into a treatment arm receiving melatonin plus standard care or a control arm receiving standard care alone. The trial's primary endpoint was sleep quality examined by the Leeds Sleep Evaluation Questionnaire (LSEQ). The trial's secondary endpoints were symptoms alleviation by Day 7, intensive care unit admission, 10-day mortality, white blood cell count, lymphocyte count, C-reactive protein status, and peripheral capillary oxygen saturation. Ninety-six patients were recruited and allocated to either the melatonin arm (n = 48) or control arm (n = 48). Baseline characteristics were similar across treatment arms. There was no significant difference in symptoms on Day 7. The mean of the LSEQ scores was significantly higher in the melatonin group (p < 0.001). There was no significant difference in laboratory data, except for blood oxygen saturation, which has improved significantly in the melatonin group compared with the control group (95.81% vs. 93.65% respectively, p = 0.003). This clinical trial study showed that the combination of oral melatonin tablets and standard treatment could substantially improve sleep quality and blood oxygen saturation in hospitalized COVID-19 patients.


Subject(s)
COVID-19/drug therapy , COVID-19/physiopathology , Melatonin/therapeutic use , Sleep/drug effects , Female , Hospitalization , Humans , Intensive Care Units , Male , Middle Aged , Oxygen/blood
12.
J Evid Based Integr Med ; 26: 2515690X211036875, 2021.
Article in English | MEDLINE | ID: covidwho-1356989

ABSTRACT

Worldwide, the turmoil of the SARS-CoV-2 (COVID-19) pandemic has generated a burst of research efforts in search of effective prevention and treatment modalities. Current recommendations on natural supplements arise from mostly anecdotal evidence in other viral infections and expert opinion, and many clinical trials are ongoing. Here the authors review the evidence and rationale for the use of natural supplements for prevention and treatment of COVID-19, including those with potential benefit and those with potential harms. Specifically, the authors review probiotics, dietary patterns, micronutrients, antioxidants, polyphenols, melatonin, and cannabinoids. Authors critically evaluated and summarized the biomedical literature published in peer-reviewed journals, preprint servers, and current guidelines recommended by expert scientific governing bodies. Ongoing and future trials registered on clinicaltrials.gov were also recorded, appraised, and considered in conjunction with the literature findings. In light of the controversial issues surrounding the manufacturing and marketing of natural supplements and limited scientific evidence available, the authors assessed the available data and present this review to equip clinicians with the necessary information regarding the evidence for and potential harms of usage to promote open discussions with patients who are considering dietary supplements to prevent and treat COVID-19.


Subject(s)
Antioxidants/therapeutic use , COVID-19/drug therapy , Dietary Supplements , Micronutrients/therapeutic use , Plant Extracts/therapeutic use , Antioxidants/pharmacology , Cannabinoids/pharmacology , Cannabinoids/therapeutic use , Humans , Melatonin/pharmacology , Melatonin/therapeutic use , Micronutrients/pharmacology , Niacinamide/pharmacology , Niacinamide/therapeutic use , Plant Extracts/pharmacology , Polyphenols/pharmacology , Polyphenols/therapeutic use , Probiotics/therapeutic use , SARS-CoV-2
13.
Int J Mol Sci ; 22(16)2021 Aug 11.
Article in English | MEDLINE | ID: covidwho-1354985

ABSTRACT

Melatonin is registered to treat circadian rhythm sleep-wake disorders and insomnia in patients aged 55 years and over. The essential role of the circadian sleep rhythm in the deterioration of sleep quality during COVID-19 confinement and the lack of an adverse effect of melatonin on respiratory drive indicate that melatonin has the potential to be a recommended treatment for sleep disturbances related to COVID-19. This review article describes the effects of melatonin additional to its sleep-related effects, which make this drug an attractive therapeutic option for treating patients with COVID-19. The preclinical data suggest that melatonin may inhibit COVID-19 progression. It may lower the risk of the entrance of the SARS-CoV-2 virus into cells, reduce uncontrolled hyper-inflammation and the activation of immune cells, limit the damage of tissues and multiorgan failure due to the action of free radicals, and reduce ventilator-induced lung injury and the risk of disability resulting from fibrotic changes within the lungs. Melatonin may also increase the efficacy of COVID-19 vaccination. The high safety profile of melatonin and its potential anti-SARS-CoV-2 effects make this molecule a preferable drug for treating sleep disturbances in COVID-19 patients. However, randomized clinical trials are needed to verify the clinical usefulness of melatonin in the treatment of COVID-19.


Subject(s)
COVID-19/drug therapy , Melatonin/pharmacology , SARS-CoV-2/drug effects , COVID-19/virology , COVID-19 Vaccines/pharmacology , Cytokines/metabolism , Free Radical Scavengers/metabolism , Humans , Melatonin/therapeutic use , Renin-Angiotensin System , Sleep Wake Disorders/drug therapy
15.
Rev. Assoc. Med. Bras. (1992) ; 67(supl.1): 18-21, 2021.
Article in English | WHO COVID, LILACS (Americas) | ID: covidwho-1309997

ABSTRACT

SUMMARY COVID-19 infection is more severe in patients with type 2 diabetes mellitus (DM2). The severity of this viral infection is associated with an intense inflammatory activity. DM2 is a disease that also determines a greater degree of systemic inflammation. This is due to hyperglycemia, the higher prevalence of sleep disorders and also the low levels of melatonin, a substance with anti-inflammatory actions, in these patients. In this article, we suggest that exogenous melatonin may have an important anti-inflammatory role in preventing severe forms of COVID -19 in patients with DM2.


Subject(s)
Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/drug therapy , COVID-19 , Hyperglycemia , SARS-CoV-2 , Melatonin/therapeutic use
16.
Arch Med Res ; 53(1): 79-85, 2022 01.
Article in English | MEDLINE | ID: covidwho-1298635

ABSTRACT

BACKGROUND: Melatonin has been known as an anti-inflammatory agent and immune modulator that may address progressive pathophysiology of coronavirus disease 2019 (COVID-19). AIM OF THE STUDY: To evaluate the clinical efficacy of adjuvant, use of melatonin in patients with COVID-19. METHODS: This single-center, double-blind, randomized clinical trial included 74 hospitalized patients with confirmed mild to moderate COVID-19 at Baqiyatallah Hospital in Tehran, Iran, from April 25, 2020-June 5, 2020. Patients were randomly assigned in a 1:1 ratio to receive standard of care and standard of care plus melatonin at a dose of 3 mg three times daily for 14 d. Clinical characteristics, laboratory, and radiological findings were assessed and compared between two study groups at baseline and post-intervention. Safety and clinical outcomes were followed up for four weeks. RESULTS: A total of 24 patients in the intervention group and 20 patients in the control group completed the treatment. Compared with the control group, the clinical symptoms such as cough, dyspnea, and fatigue, as well as the level of CRP and the pulmonary involvement in the intervention group had significantly improved (p <0.05). The mean time of hospital discharge of patients and return to baseline health was significantly shorter in the intervention group compared to the control group (p <0.05). No deaths and adverse events were observed in both groups. CONCLUSIONS: Adjuvant use of melatonin has a potential to improve clinical symptoms of COVID-19 patients and contribute to a faster return of patients to baseline health.


Subject(s)
COVID-19 , Melatonin , Double-Blind Method , Humans , Iran , Melatonin/therapeutic use , SARS-CoV-2 , Treatment Outcome
17.
Endocr Pract ; 27(8): 850-855, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1263262

ABSTRACT

OBJECTIVE: To discuss the use of melatonin as an early treatment option on the first day of diagnosis for COVID-19. METHODS: Medical Subject Headings terms "COVID-19" and "viral diseases" were manually searched on PubMed, and relevant articles were included. RESULTS: The results showed that melatonin acts to reduce reactive oxygen species-mediated damage, cytokine-induced inflammation, and lymphopenia in viral diseases similar to COVID-19. CONCLUSION: These conclusions provide evidence for potential benefits in melatonin use for COVID-19 treatment as early as the day of diagnosis.


Subject(s)
COVID-19 , Coronavirus Infections , Melatonin , COVID-19/drug therapy , Humans , Melatonin/therapeutic use , SARS-CoV-2
18.
Geriatr Nurs ; 42(4): 955-958, 2021.
Article in English | MEDLINE | ID: covidwho-1258371

ABSTRACT

Whereas hospitalists and intensivists are treating the life-threatening respiratory conditions that often accompany COVID-19, delirium prevention, identification, and treatment may inadvertently be taking a backseat. However, delirium identification is important as it can serve as a key marker for hospital providers to identify COVID patients at risk for poor outcomes including ICU stay and death.2 COVID delirium has been difficult to manage because some COVID treatment methods are inherently deliriogenic and some medications traditionally used to manage delirium have been rendered ineffective among this population. Inpatient neurology and psychiatry practitioners are having to postulate new treatment techniques; one such medication algorithm can be found within this piece. It is important that delirium doesn't get lost in the chaos that is management of the COVID patient.


Subject(s)
Antipsychotic Agents/therapeutic use , COVID-19 , Delirium/drug therapy , Confusion , Delirium/complications , Delirium/prevention & control , Humans , Intensive Care Units , Melatonin/therapeutic use , Neurology , Psychiatry , SARS-CoV-2 , Valproic Acid/therapeutic use
19.
Med Hypotheses ; 151: 110588, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1157615

ABSTRACT

Daily new information emerges regarding the COVID-19, infection of SARS-CoV-2, which is considered a global pandemic. Angiotensin-converting enzyme 2 (ACE2) and transmembrane protease serine 2 (TMPRSS2) are required to complete the viral invasion pathway and are present in the oral mucosa, gingiva and periodontal pocket. Thus, increasing the likelihood of periodontitis and gingivitis caused by COVID-19. The cytokine storm during COVID-19 similarly arises during periodontal inflammation. Studies have reported that NOD-Like Receptor family pyrin domain-containing 3 (NLRP3) inflammasome is significant in the cytokine storm. Recently, the course of the COVID-19 has been related to the melatonin levels in both COVID-19 and periodontal diseases. It is known that melatonin prevents the activation of NLRP3 inflammasome. In light of these findings, we think that melatonin treatment during COVID-19 or periodontal diseases may prevent the damage seen in periodontal tissues by preventing the activation of NLRP3 inflammasome.


Subject(s)
COVID-19 , Melatonin , Periodontitis , Humans , Inflammasomes , Melatonin/therapeutic use , NLR Family, Pyrin Domain-Containing 3 Protein , SARS-CoV-2
20.
J Pineal Res ; 71(1): e12732, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1148081

ABSTRACT

Data indicate that controlling inflammatory responses to COVID-19 may be as important as antiviral therapies or could be an important adjunctive approach. Melatonin possesses anti-inflammation, antioxidation, and immune-enhancing features directly and/or indirectly through its own receptor signaling and is therefore well suited to reduce the severity of COVID-19. Studies have proposed that melatonin regulates COVID-19-associated proteins directly through regulation of molecules such as calmodulin (CALM) 1 and CALM 2, calreticulin (CalR), or myeloperoxidase (MPO) and/or indirectly through actions on GPCR (eg, MTNR1A, MTNR1B) and nuclear (eg, RORα, RORß) melatonin receptor signaling. However, the exact mechanism(s) and doses by which melatonin reduces the severity of COVID-19 is still open for debate, warranting the need for further testing of melatonin in placebo-controlled randomized clinical trials for COVID-19.


Subject(s)
Anti-Inflammatory Agents/therapeutic use , COVID-19/drug therapy , Melatonin/therapeutic use , Receptors, Melatonin/agonists , SARS-CoV-2/pathogenicity , COVID-19/immunology , COVID-19/metabolism , COVID-19/virology , Host-Pathogen Interactions , Humans , Receptors, Melatonin/metabolism , SARS-CoV-2/immunology , Severity of Illness Index , Signal Transduction
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