Razi Drug Research Center, Iran University of Medical Sciences, Tehran, Iran.
Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Life Sci. 2022 Oct 15;307:120866. doi: 10.1016/j.lfs.2022.120866. Epub 2022 Aug 6.
Severe COVID-19 is associated with the dynamic changes in coagulation parameters. Coagulopathy is considered as a major extra-pulmonary risk factor for severity and mortality of COVID-19; patients with elevated levels of coagulation biomarkers have poorer in-hospital outcomes. Oxidative stress, alterations in the activity of cytochrome P450 enzymes, development of the cytokine storm and inflammation, endothelial dysfunction, angiotensin-converting enzyme 2 (ACE2) enzyme malfunction and renin-angiotensin system (RAS) imbalance are among other mechanisms suggested to be involved in the coagulopathy induced by severe acute respiratory syndrome coronavirus (SARS-CoV-2). The activity and function of coagulation factors are reported to have a circadian component. Melatonin, a multipotential neurohormone secreted by the pineal gland exclusively at night, regulates the cytokine system and the coagulation cascade in infections such as those caused by coronaviruses. Herein, we review the mechanisms and beneficial effects of melatonin against coagulopathy induced by SARS-CoV-2 infection.
严重的 COVID-19 与凝血参数的动态变化有关。凝血功能障碍被认为是 COVID-19 严重程度和死亡率的主要肺外危险因素；凝血生物标志物水平升高的患者住院结局较差。氧化应激、细胞色素 P450 酶活性改变、细胞因子风暴和炎症的发展、内皮功能障碍、血管紧张素转换酶 2（ACE2）酶功能障碍和肾素-血管紧张素系统（RAS）失衡等其他机制被认为与严重急性呼吸综合征冠状病毒（SARS-CoV-2）引起的凝血功能障碍有关。据报道，凝血因子的活性和功能具有昼夜节律成分。褪黑素是由松果腺在夜间专门分泌的一种多功能神经激素，可调节细胞因子系统和凝血级联反应，如冠状病毒引起的感染。在此，我们综述了褪黑素对 SARS-CoV-2 感染引起的凝血功能障碍的作用机制和有益作用。
