(1/n) N-acetylcysteine (NAC) has a great potential to be beneficial in the treatment of #COVID19 & prevention of #SARSCoV2 infection.
Good review article: ncbi.nlm.nih.gov/pmc/articles/P…
Unfortunately, NAC is currently given far too little attention.
(2/n) NAC is a precursor of the antioxidant glutathione, it can boost the immune system, suppress viral replication & reduce inflammation.
(3/n) NAC intake (6 months, 600 mg twice daily):
- significant reduction of influenza infections
- reduced severity and duration of most influenza symptoms
pubmed.ncbi.nlm.nih.gov/9230243/
(4/n)
(5/n) NAC has been demonstrated to inhibit the NF-κB pathway (RNA viruses need an active NF-κB pathway), and inhibits the replication of viruses, e.g. the human influenza virus (H5N1): pubmed.ncbi.nlm.nih.gov/19732754/
(6/n) The main protease (Mpro) in SARS-CoV-2 is required for viral replication.
NAC seems to bind to Cys-145, an active site of Mpro, which could potentially inhibit its protease activity and thus viral replication: chemrxiv.org/engage/chemrxi…
(7/n) NAC at clinically obtainable concentrations by inhalation has been shown to inhibit neutrophil & monocyte chemotaxis & associated oxidative burst:
sciencedirect.com/science/articl…
(8/n) NAC can reduce the incidence of pneumonia.
Mechanically ventilated patients can develop pneumonia. NAC (600 mg) treated patients developed significantly less pneumonia (26.6% vs 46.6%). Also reduced hospital stay & higher recovery rate was noted: pubmed.ncbi.nlm.nih.gov/29770192/
(9/n) In patients with mild-to-moderate acute lung injury, intravenous NAC treatment (40mg/kg/day) for 3 days significantly improved systemic oxygenation, reduced the need for ventilatory support & also slightly reduced the mortality rate:
pubmed.ncbi.nlm.nih.gov/8275731/
(10/n) Effect of iv NAC on clinical & laboratory outcomes in a G6PD-deficient #COVID19 patient:
NAC blocked hemolysis &elevation of liver enzymes, CRP & ferritin. It allowed removal from respirator. Full recovery of the G6PD-deficient patient:
sciencedirect.com/science/articl…
(11/n) The authos of the review (ncbi.nlm.nih.gov/pmc/articles/P…) suggest the following therapeutic strategy to combat #COVID19 with NAC:
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