N-Acetylcysteine as a Potential Treatment for COVID-19

Rangel-Méndez, Jorge Aarón; Moo-Puc, Rosa

doi:10.2217/fmb-2020-0074

Cited by 64 publications

(76 citation statements)

References 15 publications

(24 reference statements)

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“…71 Clearly, the potential anti-COVID-19 mechanisms and properties of this thiol have to be substantiated in controlled clinical trials, some of which are now in progress. 12,72…”

Section: Discussionmentioning

confidence: 99%

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Rationale for the use of N ‐acetylcysteine in both prevention and adjuvant therapy of COVID‐19

Balansky²,

2020

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COVID‐19 may cause pneumonia, acute respiratory distress syndrome, cardiovascular alterations, and multiple organ failure, which have been ascribed to a cytokine storm, a systemic inflammatory response, and an attack by the immune system. Moreover, an oxidative stress imbalance has been demonstrated to occur in COVID‐19 patients. N‐ Acetyl‐L‐cysteine (NAC) is a precursor of reduced glutathione (GSH). Due to its tolerability, this pleiotropic drug has been proposed not only as a mucolytic agent, but also as a preventive/therapeutic agent in a variety of disorders involving GSH depletion and oxidative stress. At very high doses, NAC is also used as an antidote against paracetamol intoxication. Thiols block the angiotensin‐converting enzyme 2 thereby hampering penetration of SARS‐CoV‐2 into cells. Based on a broad range of antioxidant and anti‐inflammatory mechanisms, which are herein reviewed, the oral administration of NAC is likely to attenuate the risk of developing COVID‐19, as it was previously demonstrated for influenza and influenza‐like illnesses. Moreover, high‐dose intravenous NAC may be expected to play an adjuvant role in the treatment of severe COVID‐19 cases and in the control of its lethal complications, also including pulmonary and cardiovascular adverse events.

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“…71 Clearly, the potential anti-COVID-19 mechanisms and properties of this thiol have to be substantiated in controlled clinical trials, some of which are now in progress. 12,72…”

Section: Discussionmentioning

confidence: 99%

“…11 By blocking ACE, NAC may provide protection from the deleterious effects of angiotensin II, a potentially useful activity in SARS-CoV-2 infection. 12…”

Section: Sars-cov-2 Binding To Cellsmentioning

confidence: 99%

Rationale for the use of N ‐acetylcysteine in both prevention and adjuvant therapy of COVID‐19

Balansky²,

2020

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“…It is notable that PhyCB, phase 2 inducers, melatonin, N-acetylcysteine, berberine, glucosamine, and zinc have already been suggested for use in the management of COVID-19 [ 235 , 236 , 237 , 238 , 239 , 240 , 241 , 242 , 243 , 244 , 245 ]. The NADPH oxidase-inhibitory activity PhyCB may have potential for up-regulating the type 1 interferon response to SARS-CoV-2 and other RNA viruses, and may also act to suppress the induction of tissue factor, a likely trigger for the thrombotic complications of COVID-19 [ 235 , 236 ].…”

Section: Pertinence To the Management Of Covid-19mentioning

confidence: 99%

Nutraceutical Strategies for Suppressing NLRP3 Inflammasome Activation: Pertinence to the Management of COVID-19 and Beyond

et al. 2020

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Inflammasomes are intracellular protein complexes that form in response to a variety of stress signals and that serve to catalyze the proteolytic conversion of pro-interleukin-1β and pro-interleukin-18 to active interleukin-1β and interleukin-18, central mediators of the inflammatory response; inflammasomes can also promote a type of cell death known as pyroptosis. The NLRP3 inflammasome has received the most study and plays an important pathogenic role in a vast range of pathologies associated with inflammation—including atherosclerosis, myocardial infarction, the complications of diabetes, neurological and autoimmune disorders, dry macular degeneration, gout, and the cytokine storm phase of COVID-19. A consideration of the molecular biology underlying inflammasome priming and activation enables the prediction that a range of nutraceuticals may have clinical potential for suppressing inflammasome activity—antioxidants including phycocyanobilin, phase 2 inducers, melatonin, and N-acetylcysteine, the AMPK activator berberine, glucosamine, zinc, and various nutraceuticals that support generation of hydrogen sulfide. Complex nutraceuticals or functional foods featuring a number of these agents may find utility in the prevention and control of a wide range of medical disorders.

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“…Similar studies on N acetyl cysteine like N-acetyl cysteine as a potential treatment for COVID-19 by Rangel Mendez et al has shown positive results in the COVID-19 patients and explored the potential of the drug to help flatten the exponential contagion curve. 22…”

Section: Discussionmentioning

confidence: 99%

The beneficial role of N-acetylcysteine as an adjunctive drug in treatment of COVID-19 patients in a tertiary care hospital in India: an observational study

et al. 2020

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Background: N-acetyl cysteine, a mucolytic agent, demonstrates free radical scavenging and anti-inflammatory properties, and prevents endothelial dysfunction by inhibition of NF-KB and formation of no adducts. This has a potential role to tackle cytokine storms, endothelial dysfunction and prothrombotic state observed in COVID-19 manifestations like ARDS and Multi organ dysfunction.Methods: Institution based descriptive cross sectional study, 164 patients from laboratory confirmed RT PCR positive COVID-19 patients, in the study period from 27th May 2020 to 10th August 2020, were assessed, in medical college Kolkata, a dedicated COVID-19 care facility.Results: It was observed that moderate-severe patients who received N-acetyl cysteine along with standard therapy had average hospital stay duration of 12 days, higher rate of discharge, average duration of oxygen therapy of 8 days, less number of deaths and reduced transfer to critical care facilities.Conclusions: N-acetyl cysteine can be considered as an adjunctive therapy with standard protocol driven care, due to its beneficial anti-inflammatory and free radical scavenging properties.

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N-Acetylcysteine as a Potential Treatment for COVID-19

Abstract: Oral administration of NAC (600 mg/day) could function as a preventive measure, particularly in those repeatedly exposed to possible SARS-CoV-2 carriers (e.g., health workers). "

Cited by 64 publications

References 15 publications

Rationale for the use of N ‐acetylcysteine in both prevention and adjuvant therapy of COVID‐19

Rationale for the use of N ‐acetylcysteine in both prevention and adjuvant therapy of COVID‐19

Nutraceutical Strategies for Suppressing NLRP3 Inflammasome Activation: Pertinence to the Management of COVID-19 and Beyond

The beneficial role of N-acetylcysteine as an adjunctive drug in treatment of COVID-19 patients in a tertiary care hospital in India: an observational study

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