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Role of N-Acetylcisteine as Antioxidant in COVID-19



At the end of December 2019, there was an outbreak of pneumonia of unknown etiology with symptoms of fever, dry cough, fatigue and gastrointestinal symptoms at seafood market, Huanan Market, Wuhan, Hubei, China. Initial outbreak was reported on the market in December 2019 and involved about 66% population of the workers there. Coronavirus Disease 2019 (COVID-19) is a contagious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). SARS-CoV-2 is a new type of coronavirus that has never been previously identified in humans.
N-acetylcysteine (NAC) is a metabolite of sulfur-containing amino acid cysteine. This drug has molecular formula HSCH2CH(NHCOCH3)CO2H and a molecular weight of 163.19. In human, it can be given orally or by intravenous infusion and can also be inhaled using a nebulizer. Significant increases in blood serum glutathione reductase (GR) levels, due to an imbalance of oxidative stress, have occurred in COVID-19 patients, especially when admitted to intensive care unit (ICU). From data set of several literature, endogenous deficiency in GSH can underlie severe manifestations and deaths due to COVID-19. N-acetylcisteine (NAC) is used in a variety of conditions for recovery or protection from decreased GSH levels and has a wide margin of safety. This is useful in treating ARDS from other causes and can reduce or prevent lung damage in COVID-19 patients. NAC has been shown to have protective mechanisms against various conditions associated with COVID-19 and its comorbidities, including cardiovascular disease. NAC given intravenously has been shown to potentiate vasodilator, anti-inflammatory and anti-aggregating effects of nitroglycerin, and these beneficial interactions have translated into improved outcomes, such as in acute myocardial infarction, unstable angina, and acute pulmonary edema. NAC administration has been incorporated into a strategy aimed at maintaining endothelial function and limiting microthrombosis in severe cases of COVID-19.


N-acetylcisteine, COVID-19, antioxidant


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