The omicron variant (B.529) of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which emerged in late 2021, caused panic worldwide due to its contagiousness and multiple mutations in the spike protein compared to the Delta variant (B.617.2). There is currently no specific antiviral available to treat Coronavirus disease 2019 (COVID-19). However, studies on neutralizing monoclonal antibodies (mAb) developed to fight COVID-19 are growing and gaining traction. REGN-COV2 (Regeneron or imdevimab-casirivimab combination), which has been shown in recent studies to be less affected by Omicron's RBD (receptor binding domain) mutations among other mAb cocktails, plays an important role in adjuvant therapy against COVID-19. On the other hand, it is known that melatonin, which has antioxidant and immunomodulatory effects, can prevent a possible cytokine storm, and other severe symptoms that may develop in the event of viral invasion. Along with all these findings, we believe it is crucial to evaluate the use of melatonin with REGN-COV2, a cocktail of mAbs, as an adjuvant in the treatment and prevention of COVID-19, particularly in immunocompromised and elderly patients.

With the ongoing pandemic declared by the World Health Organization,the number of hospitalizations and deaths caused by COVID-19 is increasing dramatically. As new variants of SARS-CoV-2 emerge, new combination therapies are needed to reduce the risk of COVID- 19spreadduring this time of increased transmission risk. In this case, it is vitalto strengthen the immune system against highly inflammatory conditions such as the cytokine storm caused by COVID-19. This brief review highlights the benefits of taking melatonin and the new antiviral drug molnupiravir together in the treatment of COVID-19. Webelieve that this combination therapy against COVID-19 would be of great benefit and should be considered as an adjuvant therapy in the treatment of this disease. Bangladesh Journal of Medical Science Vol. 22 No. 01 January’23 Page : 32-37