Possible Application of Melatonin in Long COVID.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
Melatonin | decrease | the signs and symptoms of SARS-CoV-2 infection | - | - | may be particularly effective at reducing | #1 |
Melatonin | decrease | delirium | COVID patients in the intensive care unit | - | effective in treating | #2 |
Melatonin | decrease | the circadian imbalance | COVID patients in the intensive care unit | - | effective in restoring | #3 |
Melatonin | decrease | several COVID-19 comorbidities, including diabetes, metabolic syndrome, and ischemic and non-ischemic cardiovascular diseases | - | - | aids in the prevention of | #4 |
Melatonin | decrease | cognitive deterioration ("brain fog") and pain in the ME/CFS syndrome-like documented in long COVID | long COVID patients | - | application as a neuroprotective agent to control | #5 |
Clinical sequelae and symptoms for a considerable number of COVID-19 patients can linger for months beyond the acute stage of SARS-CoV-2 infection, "long COVID". Among the long-term consequences of SARS-CoV-2 infection, cognitive issues (especially memory loss or "brain fog"), chronic fatigue, myalgia, and muscular weakness resembling myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) are of importance. Melatonin may be particularly effective at reducing the signs and symptoms of SARS-CoV-2 infection due to its functions as an antioxidant, anti-inflammatory, and immuno-modulatory agent. Melatonin is also a chronobiotic medication effective in treating delirium and restoring the circadian imbalance seen in COVID patients in the intensive care unit. Additionally, as a cytoprotector, melatonin aids in the prevention of several COVID-19 comorbidities, including diabetes, metabolic syndrome, and ischemic and non-ischemic cardiovascular diseases. This narrative review discusses the application of melatonin as a neuroprotective agent to control cognitive deterioration ("brain fog") and pain in the ME/CFS syndrome-like documented in long COVID. Further studies on the therapeutic use of melatonin in the neurological sequelae of SARS-CoV-2 infection are warranted.