Coronavirus in Pregnancy: The Role of Melatonin

The effects of COVID-19 on pregnant individuals are unclear due to a series of physiological changes and immune system adaptations that may affect the development of the fetus. There is evidence supporting the role of melatonin in human pregnancy, and it appears that melatonin is essential for a successful pregnancy. However, in pathological conditions, such as during SARS-CoV-2 infection, melatonin levels can be significantly inhibited. In addition, melatonin, a powerful endogen antioxidant, free radical scavenger, and anti-inflammatory molecule, has been reported to exert beneficial effects on viral diseases such as COVID-19. This review focuses on the current evidence regarding the physiopathology of COVID-19 in pregnancy conditions, the role of melatonin during pregnancy, and the use of melatonin as a promising treatment. Addressing these points should help us understand the knowledge currently available about COVID-19 during pregnancy and explore the possible beneficial effects of melatonin. Physiological and immunological adaptations during pregnancy may result in systemic effects that greatly contribute to the development of acute viral infectious diseases such as COVID-19. Melatonin as an adjuvant in COVID-19 treatment has anti-inflammatory, anti-oxidative, and immune response regulatory functions. The strategy that melatonin offers is to slow the cytokine storm observed and reduce oxidative damage to enhance the resistance of individuals and provide additional survival time. Although the direct evidence of melatonin application in COVID-19 is unclear, both its use in experimental animal models and studies on humans has consistently documented its efficacy and safety, and its use by COVID-19 patients would be highly beneficial.