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Rationale for the use of N-acetylcysteine in both prevention and adjuvant therapy of COVID-19.
De Flora, Silvio; Balansky, Roumen; La Maestra, Sebastiano.
  • De Flora S; Department of Health Sciences, University of Genoa, Genoa, Italy.
  • Balansky R; National Centre of Oncology, Sofia, Bulgaria.
  • La Maestra S; Department of Health Sciences, University of Genoa, Genoa, Italy.
FASEB J ; 34(10): 13185-13193, 2020 10.
Article in English | MEDLINE | ID: covidwho-704967
ABSTRACT
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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Full text: Available Collection: International databases Database: MEDLINE Main subject: Acetylcysteine / Virus Internalization / SARS-CoV-2 / COVID-19 / COVID-19 Drug Treatment / Antioxidants Type of study: Observational study / Prognostic study Limits: Humans Language: English Journal: FASEB J Journal subject: Biology / Physiology Year: 2020 Document Type: Article Affiliation country: Fj.202001807

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Acetylcysteine / Virus Internalization / SARS-CoV-2 / COVID-19 / COVID-19 Drug Treatment / Antioxidants Type of study: Observational study / Prognostic study Limits: Humans Language: English Journal: FASEB J Journal subject: Biology / Physiology Year: 2020 Document Type: Article Affiliation country: Fj.202001807