An urgent proposal for the immediate use of melatonin as an adjuvant to anti- SARS-CoV-2 vaccination

Abstract

Competition among pharmaceutical companies to develop safe and effective vaccines against SARS-CoV-2 is high. However, based on the prior experience with the influenza vaccine, up to 50% in lack of effectiveness would be found among healthy adults receiving effective vaccines against SARS-CoV-2. There is growing evidence that insufficient sleep may potentially be a pervasive and prominent factor accounting for this variability. Individuals experiencing total or partial sleep loss exhibit markedly reduced antigen-specific antibodies as compared to healthy sleepers. Besides, pre-vaccination sleep quality is also an important contributing factor. Several meta-analyses and expert consensus reports support the view that the chronobiotic/hypnotic properties of melatonin are useful in patients with primary sleep disorders to decrease sleep onset latency and to increase total sleep time. Hence, the prescription of melatonin for at least 2 weeks prior to vaccination can be a useful approach to improve sleep quality and to ensure that the vaccination is performed at a moment of optimal sleep conditions. Moreover, melatonin enhances the immune response to vaccines by increasing peripheral blood CD4+ T cells and IgG-expressing B cells. Administration of exogenous melatonin could increase the potency of the immune response and the duration of the immunity induced by the vaccine. Besides, melatonin could also prevent adverse effects of the vaccination due to its antioxidant and immunomodulatory properties. Therefore, the administration of melatonin from 2 weeks to at least 4 weeks after vaccination may constitute an effective means to enhance the efficacy of vaccination against SARS-CoV-2.

Health of the territory’s population: the main factors and trends in reducing their impact

“…To ensure healthy sleep it is necessary to refuse food and active exercises a few hours before sleep, go to bed at the same time, create necessary conditions for sleep (air temperature -18-20°C, humidity -50-70%, comfortable sleeping accessories). Healthy sleep is capable of normalizing the body's work, increasing the protective mechanisms of the human immune system [29,30].…”

Melatonin as a Potential Adjuvant Treatment for COVID-19 beyond Sleep Disorders

“…Particular attention should be paid to the possibility of using melatonin in connection with vaccination [28]. The use of melatonin in the period before falling ill could also potentially reduce the severity of the disease and increase the percentage of people who are asymptomatic and suffer a mildly advanced disease.…”

“…Antioxidant properties Reduction of post-covid pulmonary fibrosis 0.5-5 mg 1 Preferred prolonged-release form [17]. 2 high doses should be avoided, as they may decrease the immune response [28]. 3 The optimal dose is unknown due to a lack of randomized clinical trials.…”

The Coronavirus Disease 2019 (COVID-19): Key Emphasis on Melatonin Safety and Therapeutic Efficacy

“…Noticeably, the immunomodulatory action as adjuvant of melatonin may enhance the effectivity of vaccination in immunocompromised individuals, such as aged people and patients with comorbidities, who are at great risk of lethal COVID-19. Specifically, melatonin pre-treatment can increase the intensity and temporal coverage of the immune response, enhancing natural killer and CD4 + cells in addition to reducing the side effects of vaccination [23,32]. Melatonin has also been documented targeting the activity of CD147, which takes part in the cytokine storm that causes inflammatory injury in the lung [101].…”

“…Likewise, individuals on melatonin treatment, along with other pharmacological, genre, ethnicity, and age features, have been positively discriminated as reduced-risk for COVID-19 by a logistic regression algorithm over more than 11,000 people [28]. Moreover, the translational applicability of this molecule stands out over other therapy drug candidates to effectively and safely curtail the COVID-19 pandemic [10,25,29], as well as to enhance the immune response to vaccination [16,[30][31][32].…”