Text and Photo by Henrylito D. Tacio
When an unknown disease (later known as coronavirus disease 2019 or COVID-19) spread throughout Wuhan, China in December last year, health experts said the outbreak would only be local. But by January, the disease had been reported in other parts of the world.
On January 30, the Geneva-based World Health Organization (WHO) declared the COVID-19 outbreak a “public health emergency of international concern.” By March, it was already considered a pandemic.
The virus, called SARS-CoV-2, is primarily transmitted via respiratory droplets as it is a distant cousin of the original Severe Acute Respiratory Syndrome virus. When a person sneezes, laughs, sings, talks, or even breathes, these droplets can travel into another person’s mouth or nose and establish an infection.
Recommended measures to prevent infection include:
- Frequent hand washing.
- Face coverings.
- Maintaining physical distance from others.
- Covering coughs.
- Keeping unwashed hands away from the face.
COVID-19 affects different people in different ways. Most infected people develop mild to moderate illness and recover without hospitalization. But some groups of people carry a bigger risk of infection and even an increased chance of dying from COVID-19. These are the elderly, pregnant women, people with underlying medical conditions (like diabetes or liver disease), and compromised immune systems.
The most common symptoms of COVID-19 are fever, dry cough, and tiredness. The less common symptoms include aches and pains, sore throat, diarrhea, conjunctivitis, headache, loss of taste or smell, rash on their skin, or discoloration of fingers and toes.
Right now, there are no vaccines nor specific anti-viral treatments available for COVID-19. Management involves the treatment of the symptoms, supportive care, isolation, and experimental measures.
However, there are some testing and trials conducted in various parts of the world. In the Philippines, the Department of Science and Technology (DOST) has approved the clinical trials on the use of melatonin as a supplementary treatment for COVID-19.
The clinical trials – which involves 350 patients over a four-month period – are being conducted by a team from Manila Doctors Hospital (MDH) led by Dr. Rafael Castillo, a cardiologist who’s also a newspaper columnist.
“High-dose melatonin is being considered as a potential treatment for COVID-19,” wrote Dr. Castillo in Health and Lifestyle, a monthly publication where he serves as editor-in-chief. “While the hormone does not kill the novel coronavirus, it is said to neutralize its damaging effects on the body.”
The MDH is the first in the world to try high-dose melatonin for high-risk COVID-19 patients. It has been reported that several patients who were given the hormone already had adult respiratory distress syndrome before taking melatonin, but they all survived.
One of those who survived was the father of a cardiologist. “Her father was about to be intubated and hooked to a breathing machine because his pneumonia was getting worse,” Dr. Castillo reported. “After being given high-dose melatonin for three days, however, his condition improved and nine days later, he was discharged.”
Studies abroad have also confirmed the use of melatonin in combating COVID-19. “A body infected with the novel coronavirus suffers from excessive inflammation, oxidation, and exaggerated immune responses, which contribute to acute lung respiratory distress syndrome,” Dr. Castillo explained.
“Since melatonin is an antioxidant, anti-inflammatory and immune-modulating hormone, it is said to be protective against severe viral-induced diseases like SARS and COVID-19,” he added.
The MDH is teaming up with the DOST’s Philippine Council for Health Research and Development (PCHRD) in the study.
“We are aiming to build on the use of melatonin as a commonly available supplement to support our fight against COVID-19,” PCHRD Executive Director Jaime Montoya said in a press statement. “If the project proves to be successful, we may be able to de-escalate COVID-19 cases better, and possibly reduce the mortality rate of the infection.”
Melatonin is a natural hormone made by the body’s pineal gland. This is a pea-sized gland located just above the middle of the brain, which helps the body know when it’s time to sleep and wake up.
“Normally, your body makes more melatonin at night,” the website, wedMD.com, states. “Levels usually start to go up in the evening once the sun sets. They drop in the morning when the sun goes up. The amount of light you get each day – plus your own body clock – set how much your body makes.”
Melatonin is called the “Dracula of hormones” as it only comes out in the dark. “Even if the pineal gland is switched ‘on’ by the clock,” the US-based Sleep Foundation explains, “it will not produce melatonin unless the person is in a dimly lit environment.”
Melatonin production declines with age. But it is now available as a supplement, typically as an oral tablet. Most melatonin supplements are made in a laboratory.
“People commonly use melatonin for sleep disorders such as insomnia and jet lag,” says the Mayo Clinic. “Unlike with many sleep medications, you are unlikely to become dependent on melatonin, have a diminished response after repeated use (habituation) or experience a hangover effect.”
Taken orally, melatonin is generally safe. However, the Mayo Clinic says it can cause headaches, dizziness, nausea, and drowsiness. Because of the latter, doctors advise not to drive or use machinery within five hours of taking the supplement.
“Less common melatonin side effects might include short-lasting feelings of depression, mild tremor, mild anxiety, abdominal cramps, irritability, reduced alertness, confusion or disorientation and abnormally low blood pressure (hypotension),” the Mayo Clinic states.
WebMD.com also states that melatonin supplements might cause problems if you take them with some medicines, including blood-thinning medications (coagulants), drugs that suppress the immune system (immunosuppressants), diabetes drugs, and birth control pills.
Aside from COVID-19, doctors are also studying if melatonin can help with Alzheimer’s disease, cancer, amyotrophic lateral sclerosis, high nighttime blood pressure, and sleep problems in children with autism spectrum disorders.