Efficacy of melatonin in non-intensive care unit patients with COVID-19 pneumonia and sleep dysregulation

Abstract

The association of sleep disruption with a higher vulnerability to COVID-19 infection is asubject of major clinical importance. In patients with pneumonia associated with COVID-19admitted to non-intensive care unit (NICU) several factors, like the disrupting influence ofrespiratory distress, medication, greater stress due to social isolation, and lack of appropriateexposure to environmental light can be instrumental to disrupt sleep / wake cycle. Thetherapeutic potential of melatonin to counteract the consequences of COVID-19 infection hasbeen advocated. Because of its wide-ranging effects as an antioxidant, anti-inflammatory, andimmunomodulatory compound, melatonin could be unique in impairing the consequences ofSARS-CoV-2 infection. Melatonin is also an effective chronobiotic agent to reverse the circadiandisruption of social isolation and to control delirium in severely affected patients. Properlyadministered, melatonin may restore the optimal circadian pattern of the sleep-wake cycle andimprove clinical condition in pneumonia associated with COVID-19 patients. The present reviewarticle discusses the importance of maintaining normal sleep and circadian rhythmicity in NICUpatients and provides preliminary data suggesting the efficacy of melatonin (9 mg/day) to reducelength of stay of pneumonia patients associated with COVID-19 in NICU.