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Findings from a new study conducted by the Cleveland Clinic suggest that melatonin, a hormone that regulates the sleep-wake cycle and is commonly used as an over-the-counter sleep aid, may be a viable treatment option for COVID-19.
As COVID-19 continues to spread around the world, particularly with cases on the rise during what some have called the “fall peak,” the reuse of drugs already approved by the US Food and Drug Administration for new therapeutic purposes continues to be the most efficient and cost effective approach to treat or prevent disease. According to the results published today in PLOS biology, a new artificial intelligence platform developed by researchers at the Lerner Research Institute to identify possible drugs for COVID-19 repurposing has revealed that melatonin is a promising candidate.
Analysis of patient data from the Cleveland Clinic COVID-19 registry also revealed that melatonin use was associated with a nearly 30% reduced chance of testing positive for SARS-CoV-2 (the virus that causes COVID -19) after adjustment for age, race, smoking history and various comorbidities of the disease. Notably, the reduced likelihood of testing positive for the virus increased from 30 to 52 percent for African Americans when adjusted for the same variables.
“It is very important to note that these findings do not suggest that people should start taking melatonin without consulting their doctor,” said Feixiong Cheng, Ph.D., assistant staff member of the Cleveland Clinic’s Genomic Medicine Institute and lead author of the study. “Large-scale observational studies and randomized controlled trials are critical to validating the clinical benefit of melatonin for patients with COVID-19, but we are excited about the associations presented in this study and the opportunity to explore them further.”
Here, researchers leveraged the Cleveland Clinic’s networked medicine methodologies and large-scale electronic patient records to identify clinical manifestations and pathologies common between COVID-19 and other diseases. In particular, they measured the proximity between host genes / proteins and those well associated with 64 other diseases in different disease categories (malignant cancer and autoimmune, cardiovascular, metabolic, neurological and pulmonary diseases), where a greater proximity narrow indicates a greater likelihood of pathological associations between diseases.
They found, for example, that proteins associated with respiratory distress syndrome and sepsis, two leading causes of death in patients with severe COVID-19, were highly connected with multiple SARS-CoV-2 proteins. “This signals us, therefore,” explained Dr. Cheng, “that a drug already approved for the treatment of these respiratory conditions could have some use in treating COVID-19 by acting on those shared biological targets.”
Overall, they determined that autoimmune (eg, inflammatory bowel disease), pulmonary (eg, chronic obstructive pulmonary disease and pulmonary fibrosis), and neurologic (eg, depression and attention deficit disorder) diseases hyperactivity) showed significant network proximity to the SARS-CoV-2 genes / proteins and identified 34 drugs as repurposed candidates, chief among them melatonin.
“Recent studies suggest that COVID-19 is a systemic disease that affects multiple types of cells, tissues and organs, so understanding the complex interactions between the virus and other diseases is key to understanding COVID-19 related complications and identifying drugs. reusable, “said Dr. Cheng. “Our study provides a powerful integrative network medicine strategy to predict COVID-19 associated disease manifestations and facilitate the search for effective treatment.”
Yadi Zhou, Ph.D., a data scientist, and Yuan Hou, Ph.D., a postdoctoral fellow, both members of the Cheng lab, are the first authors of this study, which was supported in part by the National Institute on Aging and the National Heart, Lung, and Blood Institute, both parts of the National Institutes of Health.
Serpil Erzurum, MD, president of the Cleveland Clinic’s Lerner Research Institute; Lara Jehi, MD, chief research information officer at the Cleveland Clinic and the Cleveland Clinic COVID-19 registry leader; Reena Mehra, MD,. director of sleep disorder research, Neurologic Institute at Cleveland Clinic; and Charis Eng, MD, Ph.D., president of the Genomic Medicine Institute, are co-authors of this study.
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