Sleep, Circadian Health and Melatonin for Mitigating COVID-19 and Optimizing Vaccine Efficacy

Lee, Rachel U.; Glickman, Gena L.

In spite of the extraordinarily rapid development and high efficacy of the current vaccines, new variants or other significant mutations may render them obsolete, and unfortunately, currently approved COVID-19 therapies have only modest efficacy and are not without risk and expense (Callaway, 2021). [...]it is imperative that we seek to mitigate the negative impacts of COVID-19 with every tool in our arsenal. Viral replication is also under circadian control, and though it has not been reported to our knowledge, SARS-CoV-2 almost certainly interacts with the host circadian system. [...]if the severity of COVID-19 symptoms and clinical outcomes are the result of a battle between viral replication and host immune response, enhancing circadian health in humans and capitalizing on temporal vulnerabilities of the virus via deliberately timed vaccination and treatment may also allow us to boost their efficacy and further reduce the severity of symptoms in those with COVID-19 (Besedovsky et al., 2019;Haspel et al., 2020;Schneider et al., 2020). [...]treatment with melatonin may improve immune system function, provide protection from damage to cells under inflammatory conditions, and prevent pathogenic inflammation that may lead to autoimmunity (Besedovsky et al., 2019;Haspel et al., 2020;Schneider et al., 2020). [...]melatonin also has important antioxidant properties, which help prevent cellular damage and attenuate the tissue-damaging effects of inflammation, translating to treatment efficacy in patients with sepsis, diabetes, cardiomyopathy, and multiple sclerosis, all comorbidities that relate to COVID-19 risk (Cardinali et al., 2020).