key: cord-310999-6xef9z2w
authors: Chen, Yiting; Zhao, Anda; Xia, Yuanqing; Lyu, Jiajun; Ye, Xiuxia; Liu, Ningning; Li, Shenghui
title: In the big picture of COVID-19 pandemic: what can sleep do
date: 2020-06-10
journal: Sleep Med
DOI: 10.1016/j.sleep.2020.06.009
sha: 
doc_id: 310999
cord_uid: 6xef9z2w

nan

In the big picture of COVID-19 pandemic: what can sleep do Q3 The world is grappling with the coronavirus disease 2019 (COVID-19) pandemic, however, currently there is no effective antivirals or vaccines for it. Therefore, mitigating propagation of the virus and boosting immunity are of crucial importance. As suggested by clinical intervention studies, sleep is involved in an individual's susceptibility to infection [1] . Based on the emerging literature about the pathogenesis of COVID-19, we would emphasize the potential role of sleep in the prevention and control of COVID-19.

Angiotensin-converting enzyme (ACE)-2 has been recognized as the receptor of SARS-CoV-2 spike [2] . A newly published review posited that ACE2 might exhibit circadian rhythm due to indirect effects of circadian rhythm changes in the renin angiotensin system, indicating the possible link of circadian rhythm to COVID-19 susceptibility [2] . Additionally, when exposed to COVID-19 infection, a series of pro-inflammatory cytokines were activated, increasing the risk of developing a cytokine storm [3] . Sleep exerted roles in modulation of the synthesis and secretion of numerous cytokines, including detrimental interleukin (IL)-6 and tumor necrosis factor (TNF)-a, both of which were closely related with cytokine storm; and the disrupted circadian rhythm could result in certain cytokine peaks move from night to daytime [4] . Melatonin. a sleep-inducing hormone, is associated with the reduction of cytokines (eg, IL-6 and TNF-a); thus, melatonin is anti-inflammatory and immune enhancing, which has been suggested as an adjuvant therapy for COVID-19 [3] . Moreover, when infected, increased sleep in drosophila was identified as host defense to promote survival thus combat infection, further pointing out the great potential of promoting sleep in anti-infective therapy [5] .

In summary, it is highly probable that sleep involved in the pathological process of COVID-19. Furthermore, it is recommended that medical professionals educate the public on how to develop good sleep habits in order to help people to respond to this pandemic more effectively. 9  10  11  12  13  14  15  16  17  18  19  20  21  22  23  24  25  26  27  28  29  30  31  32  33  34  35  36  37  38  39  40  41  42  43  44  45  46  47  48  49  50  51  52  53  54 55

Sleep habits and susceptibility to the common cold

Putative contributions of circadian clock and sleep in the context of SARS-CoV-2 infection

COVID-19: melatonin as a potential adjuvant treatment

The sleep-immune crosstalk in health and disease

A sleep-inducing gene, nemuri, links sleep and immune function in Drosophila

In the big picture of COVID-19 pandemic: what can sleep do