Coronavirus Disease 2019 (COVID-19) and Its Neuroinvasive Capacity: Is It Time for Melatonin?

Cell Mol Neurobiol. 2022 Apr;42(3):489-500. doi: 10.1007/s10571-020-00938-8. Epub 2020 Aug 9.

Abstract

The world faces an exceptional new public health concern caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), subsequently termed the coronavirus disease 2019 (COVID-19) by the World Health Organization (WHO). Although the clinical symptoms mostly have been characterized, the scientific community still doesn´t know how SARS-CoV-2 successfully reaches and spreads throughout the central nervous system (CNS) inducing brain damage. The recent detection of SARS-CoV-2 in the cerebrospinal fluid (CSF) and in frontal lobe sections from postmortem examination has confirmed the presence of the virus in neural tissue. This finding reveals a new direction in the search for a neurotherapeutic strategy in the COVID-19 patients with underlying diseases. Here, we discuss the COVID-19 outbreak in a neuroinvasiveness context and suggest the therapeutic use of high doses of melatonin, which may favorably modulate the immune response and neuroinflammation caused by SARS-CoV-2. However, clinical trials elucidating the efficacy of melatonin in the prevention and clinical management in the COVID-19 patients should be actively encouraged.

Keywords: COVID-19; Central nervous system; Melatonin; Neuroinvasion; Neuroprotection; SARS-CoV-2.

Publication types

  • Review

MeSH terms

  • Animals
  • Brain / drug effects
  • Brain / pathology
  • Brain / virology
  • COVID-19 / complications
  • COVID-19 / pathology
  • COVID-19 Drug Treatment*
  • Central Nervous System / drug effects
  • Central Nervous System / pathology
  • Central Nervous System / virology*
  • Central Nervous System Agents / pharmacology
  • Central Nervous System Agents / therapeutic use
  • Central Nervous System Viral Diseases / drug therapy
  • Central Nervous System Viral Diseases / pathology
  • Humans
  • Melatonin / pharmacology
  • Melatonin / therapeutic use*
  • Neuroprotective Agents / pharmacology
  • Neuroprotective Agents / therapeutic use
  • SARS-CoV-2 / pathogenicity*

Substances

  • Central Nervous System Agents
  • Neuroprotective Agents
  • Melatonin