Speleofish
Active member
Warning! What follows may be heavy going - I apologise in advance.
Heraldopenaccess (the publisher of the paper referenced by pwhole) is regarded as a possible predatory publisher (see Yale University Library's guidelines which aim to direct their staff away from potentially dodgy journals).
The paper would never have got through the editorial process in a reputable publication and should be viewed sceptically, even if you overlook the poor grammar and the absence of proof-reading. Much of the science quoted is reasonably robust and is sourced from mainstream journals but has limited relevance to the supposed subject of the paper. Rather, it looks as if the authors have taken every biological property of melatonin that might impact on the inflammatory cascade and cut and pasted them to produce a review that makes melatonin look like a possible wonder-drug. The authors make several assertions which are not justified by the evidence they quote. For example:
"One of the reasons which contribute to such effect, at least partially, is the reduced level of melatonin in elderly people. The study presented in [19], shows that level of melatonin is quite different in young (age 26 +/-2?years) and elderly (84 +/-20?years) people. The elderly people have 3.5 times less melatonin during the day but 7.5 times less during the night. Such effect obviously contributes to general deterioration of cognitive, psychological and social functioning as well as by sleep disturbances, but primarily to immune function [4]."
It's perfectly possible that reduced melatonin levels in the elderly contribute to their vulnerability but the reality is much more complex. Even if low melatonin levels are important, there is no evidence that giving supplements will do any good. The medical literature is full of highly embarrassing studies where hormone supplements in people whose levels were low have done no good or even caused serious harm (google growth hormone trials in critical care).
The worst bit is the conclusion. Having spent a large amount of time building up melatonin as a powerful biological agent, the authors produce an anecdote to justify using melatonin to treat Covid: "One of the authors (RR) is a physician-general practitioner. Since the beginning of the pandemic, more than 80 of his patients between 23 years old and 86 years old were positively diagnosed with COVID-19 and suffered various severity of the disease. As a physician, RR has prescribed melatonin to his patients with COVID-19 based on the safety data and the efficacy evidence presented in this review. All the patients that were treated by melatonin did well and completely recovered".
They then conclude: "At present time while the world is getting infected and fighting with the COVID-19, we need a treatment that is safe and easily available and very inexpensive. Melatonin is an excellent choice, as it can act both for prevention and as an adjunct therapy against COVID-19 disease".
During the pandemic there have been a number of papers like this that make great claims for a variety of drugs (eg hydroxychloroquine) which have been shown to be completely useless and have caused harm by diverting attention away from things that are effective. This doesn't mean melatonin may not work (though I am very sceptical). However, before we use it generally, someone needs to perform a properly blinded, randomised trial. This isn't it.
Finally, I'm curious to know whether Carrier Therapeutics (the employer of the third author) make melatonin. In a reputable journal, all authors should declare their competing interests. There is no mention of interests here which makes me suspicious. I've tried to find out what Carrier produce but the information doesn't seem to be available.
Heraldopenaccess (the publisher of the paper referenced by pwhole) is regarded as a possible predatory publisher (see Yale University Library's guidelines which aim to direct their staff away from potentially dodgy journals).
The paper would never have got through the editorial process in a reputable publication and should be viewed sceptically, even if you overlook the poor grammar and the absence of proof-reading. Much of the science quoted is reasonably robust and is sourced from mainstream journals but has limited relevance to the supposed subject of the paper. Rather, it looks as if the authors have taken every biological property of melatonin that might impact on the inflammatory cascade and cut and pasted them to produce a review that makes melatonin look like a possible wonder-drug. The authors make several assertions which are not justified by the evidence they quote. For example:
"One of the reasons which contribute to such effect, at least partially, is the reduced level of melatonin in elderly people. The study presented in [19], shows that level of melatonin is quite different in young (age 26 +/-2?years) and elderly (84 +/-20?years) people. The elderly people have 3.5 times less melatonin during the day but 7.5 times less during the night. Such effect obviously contributes to general deterioration of cognitive, psychological and social functioning as well as by sleep disturbances, but primarily to immune function [4]."
It's perfectly possible that reduced melatonin levels in the elderly contribute to their vulnerability but the reality is much more complex. Even if low melatonin levels are important, there is no evidence that giving supplements will do any good. The medical literature is full of highly embarrassing studies where hormone supplements in people whose levels were low have done no good or even caused serious harm (google growth hormone trials in critical care).
The worst bit is the conclusion. Having spent a large amount of time building up melatonin as a powerful biological agent, the authors produce an anecdote to justify using melatonin to treat Covid: "One of the authors (RR) is a physician-general practitioner. Since the beginning of the pandemic, more than 80 of his patients between 23 years old and 86 years old were positively diagnosed with COVID-19 and suffered various severity of the disease. As a physician, RR has prescribed melatonin to his patients with COVID-19 based on the safety data and the efficacy evidence presented in this review. All the patients that were treated by melatonin did well and completely recovered".
They then conclude: "At present time while the world is getting infected and fighting with the COVID-19, we need a treatment that is safe and easily available and very inexpensive. Melatonin is an excellent choice, as it can act both for prevention and as an adjunct therapy against COVID-19 disease".
During the pandemic there have been a number of papers like this that make great claims for a variety of drugs (eg hydroxychloroquine) which have been shown to be completely useless and have caused harm by diverting attention away from things that are effective. This doesn't mean melatonin may not work (though I am very sceptical). However, before we use it generally, someone needs to perform a properly blinded, randomised trial. This isn't it.
Finally, I'm curious to know whether Carrier Therapeutics (the employer of the third author) make melatonin. In a reputable journal, all authors should declare their competing interests. There is no mention of interests here which makes me suspicious. I've tried to find out what Carrier produce but the information doesn't seem to be available.
