Article Publish Status: FREE
Abstract Title:

Bottom-up analysis of emergent properties of N-acetylcysteine as an adjuvant therapy for COVID-19.

Abstract Source:

World J Virol. 2021 Mar 25 ;10(2):34-52. PMID: 33816149

Abstract Author(s):

Asimina Dominari, Donald Hathaway Iii, Abdulhusein Kapasi, Trissa Paul, Sarabjot Singh Makkar, Valeria Castaneda, Sirisha Gara, Bishnu Mohan Singh, Kuchalambal Agadi, Maliha Butt, Varadha Retnakumar, Spandana Chittajallu, Rahima Taugir, Muhammad Khawar Sana, Manish Kc, Sarah Razzack, Niala Moallem, Alina Alvarez, Michael Talalaev

Article Affiliation:

Asimina Dominari


N-acetylcysteine (NAC) is an abundantly available antioxidant with a wide range of antidotal properties currently best studied for its use in treating acetaminophen overdose. It has a robustly established safety profile with easily tolerated side effects and presents the Food and Drug Administration's approval for use in treating acetaminophen overdose patients. It has been proven efficacious in off-label uses, such as in respiratory diseases, heart disease, cancer, human immunodeficiency virus infection, and seasonal influenza. Clinical trials have recently shown that NAC's capacity to replenish glutathione stores may significantly improve coronavirus disease 2019 (COVID-19) outcomes, especially in high risk individuals. Interestingly, individuals with glucose 6-phosphate dehydrogenase deficiency have been shown to experience even greater benefit. The same study has concluded that NAC's ability to mitigate the impact of the cytokine storm and prevent elevation of liver enzymes, C-reactive protein, and ferritin is associated with higher success rates weaning from the ventilator and return to normal function in COVID-19 patients. Considering the background knowledge of biochemistry, current uses of NAC in clinical practice, and newly acquired evidence on its potential efficacy against COVID-19, it is worthwhile to investigate further whether this agent can be used as a treatment or adjuvant for COVID-19.

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