Cleveland Clinic Uses Big Data Approach To Identify Melatonin As A Possible Treatment For SARS-CoV-2

Repurposing drugs that are already approved by the US FDA for therapeutic purposes continues to be the most efficient and cost-effective approach to treat or prevent diseases. Findings from this study report that a novel artificial intelligence platform developed by Lerner Research Institute to identify possible drugs to repurpose against COVID-19 has revealed melatonin to be a promising therapeutic candidate against the disease. 

Analysis of patient data from the Cleveland Clinic COVID-19 Registry has revealed that melatonin usage was associated with a 30% reduced likelihood of testing positive for SARS-CoV-2 after adjusting for race, age, smoking history, and various other disease comorbidities. The decreased likelihood of testing positive for the virus increased from 30-52% among African Americans when adjusted for the same variables.

"It is very important to note these findings do not suggest people should start to take melatonin without consulting their physician," said Feixiong Cheng, Ph.D., assistant staff in Cleveland Clinic's Genomic Medicine Institute and lead author on the study. "Large-scale observational studies and randomized controlled trials are critical to validate the clinical benefit of melatonin for patients with COVID-19, but we are excited about the associations put forth in this study and the opportunity to further explore them."

Network medicine methodologies and large scale electronic health record from the Cleveland Clinic patients were harnesses to identify clinical manifestations and pathologies common between COVID-19 and other diseases; specifically measurement proximity between host genes/proteins and those associated with 64 other diseases across several disease categories including malignant cancer and autoimmune, cardiovascular, metabolic, neurological and pulmonary disease, where closer proximity indicates a higher likelihood of pathological association between the disease. 

Among their findings, proteins associated with respiratory distress syndrome and sepsis, which are the main causes of death in those with a severe infection of this disease, were highly connected with multiple SARS-CoV-2 proteins. 

 "This signals to us, then," explained Dr. Cheng, "that a drug already approved to treat these respiratory conditions may have some utility in also treating COVID-19 by acting on those shared biological targets."

Autoimmune, pulmonary and neurological diseases were determined to show a significant network proximity to SARS-CoV-2 genes/proteins and the researchers identified 34 drugs as potential repurposing candidates with melatonin being chief among those identified. 

"Recent studies suggest that COVID-19 is a systematic disease impacting multiple cell types, tissues and organs, so knowledge of the complex interplays between the virus and other diseases is key to understanding COVID-19-related complications and identifying repurposable drugs," said Dr. Cheng. "Our study provides a powerful, integrative network medicine strategy to predict disease manifestations associated with COVID-19 and facilitate the search for an effective treatment."