Recent studies have shown a correlation between COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and the distinct, exaggerated immune response titled “cytokine storm”. This immune response leads to excessive production and accumulation of reactive oxygen species (ROS) that cause clinical signs characteristic of COVID-19 such as decreased oxygen saturation, alteration of hemoglobin properties, decreased nitric oxide (NO) bioavailability, vasoconstriction, elevated cytokines, cardiac and/or renal injury, enhanced D-dimer, leukocytosis, and an increased neutrophil to lymphocyte ratio. Particularly, neutrophil myeloperoxidase (MPO) is thought to be especially abundant and, as a result, contributes substantially to oxidative stress and the pathophysiology of COVID-19. Conversely, melatonin, a potent MPO inhibitor, has been noted for its anti-inflammatory, anti-oxidative, anti-apoptotic, and neuroprotective actions. Melatonin has been proposed as a safe therapeutic agent for COVID-19 recently, having been given with a US Food and Drug Administration emergency authorized cocktail, REGEN-COV2, for management of COVID-19 progression. This review distinctly highlights both how the destructive interactions of HOCl with tetrapyrrole rings may contribute to oxygen deficiency and hypoxia, vitamin B12 deficiency, NO deficiency, increased oxidative stress, and sleep disturbance, as well as how melatonin acts to prevent these events, thereby improving COVID-19 prognosis.

最近的研究表明，由严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 感染引起的 COVID-19 与名为“细胞因子风暴”的独特、夸张的免疫反应之间存在相关性。这种免疫反应会导致活性氧 (ROS) 的过度产生和积聚，从而导致 COVID-19 的临床症状特征，例如氧饱和度降低、血红蛋白特性改变、一氧化氮 (NO) 生物利用度降低、血管收缩、细胞因子升高、心肌梗塞等。和/或肾损伤、D-二聚体增强、白细胞增多以及中性粒细胞与淋巴细胞比率增加。特别是，中性粒细胞髓过氧化物酶（MPO）被认为特别丰富，因此对氧化应激和 COVID-19 的病理生理学有很大贡献。相反，褪黑激素是一种有效的 MPO 抑制剂，因其抗炎、抗氧化、抗凋亡和神经保护作用而闻名。最近，褪黑素被提议作为 COVID-19 的安全治疗剂，与美国食品和药物管理局紧急授权的鸡尾酒 REGEN-COV2 一起使用，用于控制 COVID-19 的进展。这篇综述明确强调了 HOCl 与四吡咯环的破坏性相互作用如何导致缺氧和缺氧、维生素 B12 缺乏、NO 缺乏、氧化应激增加和睡眠障碍，以及褪黑激素如何发挥作用来预防这些事件，从而改善COVID-19 预后。