N-acetylcysteine and coronavirus disease 2019: May it work as a beneficial preventive and adjuvant therapy? A comprehensive review study.
Acute respiratory distress syndrome
COVID-19
N-acetylcysteine
adjuvant therapy
anti-inflammatory
anti-oxidant
anti-viral
comprehensive review
coronavirus
organ failure
prevention
pulmonary
respiratory
treatment
Journal
Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences
ISSN: 1735-1995
Titre abrégé: J Res Med Sci
Pays: India
ID NLM: 101235599
Informations de publication
Date de publication:
2020
2020
Historique:
received:
07
07
2020
revised:
11
08
2020
accepted:
25
09
2020
entrez:
7
4
2021
pubmed:
8
4
2021
medline:
8
4
2021
Statut:
epublish
Résumé
Coronaviruses are major pathogens of respiratory system causing different disorders, including the common cold, Middle East respiratory syndrome, and severe acute respiratory syndrome. Today's global pandemic coronavirus disease 2019 (COVID-19) has high mortality rate, with an approximate of 20% in some studies, and is 30-60 times more fatal than the common annual influenza, However, there is still no gold standard treatment for it. N-acetylcysteine (NAC) is a well-known multi-potential drug with hypothetically probable acceptable effect on COVID-related consequences, which we completely focused in this comprehensive review. PubMed, Scopus, Science Direct, and Google Scholar have been searched. Study eligibility criteria: efficacy of NAC in various subclasses of pathogenic events which may occur during COVID-19 infection. Efficacy of NAC for managing inflammatory or any symptoms similar to symptoms of COVID-19 was reviewed and symptom improvements were assessed. Randomized clinical trials introduced NAC as an antioxidant glutathione analog and detoxifying agent promoted for different medical conditions and pulmonary disorders to alleviate influenza and reduce mortality by 50% in influenza-infected animals. The beneficial effects of NAC on viral disorders, including Epstein-Barr virus, HIV and hepatitis, and well-known vital organ damages were also exist and reported. We classified the probable effects of NAC as oxidative-regulatory and apoptotic-regulatory roles, antiviral activities, anti-inflammatory roles, preventive and therapeutic roles in lung disorders and better oxygenation functions, supportive roles in intensive care unit admitted patients and in sepsis, positive role in other comorbidities and nonpulmonary end-organ damages or failures and even in primary COVID-associated cutaneous manifestations. Based on different beneficial effects of NAC, it could be administered as a potential adjuvant therapy for COVID-19 considering patient status, contraindications, and possible drug-related adverse events.
Sections du résumé
BACKGROUND
BACKGROUND
Coronaviruses are major pathogens of respiratory system causing different disorders, including the common cold, Middle East respiratory syndrome, and severe acute respiratory syndrome. Today's global pandemic coronavirus disease 2019 (COVID-19) has high mortality rate, with an approximate of 20% in some studies, and is 30-60 times more fatal than the common annual influenza, However, there is still no gold standard treatment for it. N-acetylcysteine (NAC) is a well-known multi-potential drug with hypothetically probable acceptable effect on COVID-related consequences, which we completely focused in this comprehensive review.
MATERIALS AND METHODS
METHODS
PubMed, Scopus, Science Direct, and Google Scholar have been searched. Study eligibility criteria: efficacy of NAC in various subclasses of pathogenic events which may occur during COVID-19 infection. Efficacy of NAC for managing inflammatory or any symptoms similar to symptoms of COVID-19 was reviewed and symptom improvements were assessed.
RESULTS
RESULTS
Randomized clinical trials introduced NAC as an antioxidant glutathione analog and detoxifying agent promoted for different medical conditions and pulmonary disorders to alleviate influenza and reduce mortality by 50% in influenza-infected animals. The beneficial effects of NAC on viral disorders, including Epstein-Barr virus, HIV and hepatitis, and well-known vital organ damages were also exist and reported.
CONCLUSION
CONCLUSIONS
We classified the probable effects of NAC as oxidative-regulatory and apoptotic-regulatory roles, antiviral activities, anti-inflammatory roles, preventive and therapeutic roles in lung disorders and better oxygenation functions, supportive roles in intensive care unit admitted patients and in sepsis, positive role in other comorbidities and nonpulmonary end-organ damages or failures and even in primary COVID-associated cutaneous manifestations. Based on different beneficial effects of NAC, it could be administered as a potential adjuvant therapy for COVID-19 considering patient status, contraindications, and possible drug-related adverse events.
Identifiants
pubmed: 33824674
doi: 10.4103/jrms.JRMS_777_20
pii: JRMS-25-109
pmc: PMC8019127
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
109Informations de copyright
Copyright: © 2020 Journal of Research in Medical Sciences.
Déclaration de conflit d'intérêts
There are no conflicts of interest.
Références
Crit Care. 2017 Aug 25;21(1):228
pubmed: 28841896
COPD. 2014 Dec;11(6):705-17
pubmed: 24787454
Indian J Dermatol Venereol Leprol. 2018 Nov-Dec;84(6):652-659
pubmed: 30246706
Cell J. 2017 Apr-Jun;19(1):11-17
pubmed: 28367412
JAMA. 2018 Feb 20;319(7):698-710
pubmed: 29466596
J Am Acad Dermatol. 2002 Mar;46(3):469-70
pubmed: 11862195
Int J Chron Obstruct Pulmon Dis. 2014 Aug 06;9:825-36
pubmed: 25125976
J Fungi (Basel). 2018 Oct 15;4(4):
pubmed: 30326585
Pol Merkur Lekarski. 2017 Sep 29;43(255):140-144
pubmed: 28987048
EXCLI J. 2016 Nov 07;15:636-651
pubmed: 28096793
Crit Care Nurse. 2013 Aug;33(4):76-7
pubmed: 23908173
PLoS One. 2017 Dec 11;12(12):e0189167
pubmed: 29228057
World J Gastroenterol. 2003 Dec;9(12):2698-700
pubmed: 14669316
Life Sci. 2016 Apr 15;151:359-363
pubmed: 26946308
Expert Rev Respir Med. 2018 Aug;12(8):693-708
pubmed: 29972340
Lancet Respir Med. 2020 Apr;8(4):420-422
pubmed: 32085846
Expert Rev Respir Med. 2016;10(1):89-97
pubmed: 26567752
Dermatol Ther. 2020 Jul;33(4):e13733
pubmed: 32473070
Acta Psychiatr Scand. 2018 May;137(5):391-400
pubmed: 29457216
Crit Care. 2012 Dec 12;16(2):R66
pubmed: 22534505
Eur J Clin Pharmacol. 1996;50(6):457-61
pubmed: 8858271
Caspian J Intern Med. 2016 Fall;7(4):290-293
pubmed: 27999648
Dermatol Ther. 2020 Nov;33(6):e13867
pubmed: 32558193
JAMA. 2020 Mar 17;323(11):1061-1069
pubmed: 32031570
F1000Res. 2018 Aug 20;7:
pubmed: 30210781
Med Hypotheses. 2020 Apr 22;140:109778
pubmed: 32344315
N Engl J Med. 2020 Apr 30;382(18):1708-1720
pubmed: 32109013
PLoS One. 2012;7(3):e32503
pubmed: 22442667
Redox Rep. 2016 Jul;21(4):164-9
pubmed: 26020527
AIDS Res Hum Retroviruses. 1992 Feb;8(2):209-17
pubmed: 1540408
Lancet. 2020 Mar 28;395(10229):1054-1062
pubmed: 32171076
BMC Cardiovasc Disord. 2015 Aug 06;15:84
pubmed: 26242742
Exp Ther Med. 2017 Oct;14(4):2863-2868
pubmed: 28928799
Lancet Infect Dis. 2020 Jul;20(7):773
pubmed: 32171390
Respir Med Case Rep. 2020 Apr 21;30:101063
pubmed: 32322478
Crit Care. 2004 Aug;8(4):229-30
pubmed: 15312203
Int J Antimicrob Agents. 2020 Mar;55(3):105924
pubmed: 32081636
Respir Care. 2020 Jan;65(1):99-110
pubmed: 31506339
Ann Dermatol. 2015 Aug;27(4):450-1
pubmed: 26273165
Br J Clin Pharmacol. 2016 Jun;81(6):1021-9
pubmed: 26757427
Mol Med Rep. 2017 Nov;16(5):6626-6633
pubmed: 28901511
Chest. 2016 Mar;149(3):756-66
pubmed: 26836914
Oxid Med Cell Longev. 2018 Apr 22;2018:2835787
pubmed: 29849877
Int Surg. 2015 Apr;100(4):656-61
pubmed: 25583306
Obstet Gynecol Int. 2015;2015:817849
pubmed: 25653680
Eur Respir J. 2000 Aug;16(2):253-62
pubmed: 10968500
Pulm Pharmacol Ther. 2016 Oct;40:95-103
pubmed: 27481628
J Negat Results Biomed. 2011 May 09;10:5
pubmed: 21554703
Pathogens. 2020 Mar 04;9(3):
pubmed: 32143502
Ann Saudi Med. 2019 Jul-Aug;39(4):251-257
pubmed: 31381364
Evid Based Complement Alternat Med. 2019 Jun 13;2019:5170638
pubmed: 31312224
Lancet. 2020 Mar 21;395(10228):e52
pubmed: 32171074
J Intensive Care Med. 2018 Feb;33(2):87-96
pubmed: 28299952
Eur Rev Med Pharmacol Sci. 2020 Feb;24(4):2012-2019
pubmed: 32141570
J Clin Aesthet Dermatol. 2019 May;12(5):20-26
pubmed: 31320973
Crit Care. 2008;12(2):209
pubmed: 18423061
Int Urol Nephrol. 2018 Jun;50(6):1085-1095
pubmed: 29404930
Med J Islam Repub Iran. 2020 Sep 17;34:123
pubmed: 33437719
J Basic Clin Physiol Pharmacol. 2006;17(4):245-54
pubmed: 17338280
Int J Immunopathol Pharmacol. 2007 Apr-Jun;20(2):349-54
pubmed: 17624247
Thorax. 2015 Nov;70(11):1070-7
pubmed: 26347391
Med Sci Monit. 2010 Jul;16(7):PI13-8
pubmed: 20581787
Biochem Pharmacol. 2010 Feb 1;79(3):413-20
pubmed: 19732754
J Crit Care. 2014 Feb;29(1):182.e1-4
pubmed: 23932140
Eur J Clin Invest. 2000 Oct;30(10):915-29
pubmed: 11029607
Heart Lung. 2017 Mar - Apr;46(2):120-128
pubmed: 28109565
Eurasian J Med. 2013 Oct;45(3):167-75
pubmed: 25610275
Am J Cardiovasc Drugs. 2018 Aug;18(4):283-298
pubmed: 29623672
Nat Microbiol. 2020 Apr;5(4):536-544
pubmed: 32123347
Crit Care Resusc. 2002 Mar;4(1):21-7
pubmed: 16573399
Sarcoidosis Vasc Diffuse Lung Dis. 2009 Jul;26(2):147-54
pubmed: 20560295
Lancet. 2020 Feb 15;395(10223):497-506
pubmed: 31986264
Clin Respir J. 2018 Mar;12(3):1084-1092
pubmed: 28332341
Chin Med J (Engl). 2018 May 20;131(10):1138-1141
pubmed: 29722332
Biochem Pharmacol. 2011 Sep 1;82(5):548-55
pubmed: 21635874
Medicine (Baltimore). 2018 Nov;97(45):e13087
pubmed: 30407312
Cochrane Database Syst Rev. 2012 Sep 12;(9):CD006616
pubmed: 22972094
Med Gas Res. 2018 Apr 18;8(1):19-23
pubmed: 29770192
PLoS One. 2019 May 9;14(5):e0213862
pubmed: 31071081
Antioxidants (Basel). 2019 Apr 28;8(5):
pubmed: 31035402
ARYA Atheroscler. 2015 Jan;11(1):5-13
pubmed: 26089925
Hum Exp Toxicol. 2007 Sep;26(9):697-703
pubmed: 17984140
Exp Ther Med. 2019 Jul;18(1):802-816
pubmed: 31258714
Int Immunopharmacol. 2014 Sep;22(1):1-8
pubmed: 24968347
Sports Med. 2017 Aug;47(8):1619-1636
pubmed: 28102488
West J Emerg Med. 2013 May;14(3):218-26
pubmed: 23687539
Am Fam Physician. 2009 Aug 1;80(3):265-9
pubmed: 19621836
Dermatol Ther. 2020 Nov;33(6):e13986
pubmed: 32639077
COPD. 2014 Jun;11(3):351-8
pubmed: 24378052
JAMA Intern Med. 2020 Jul 1;180(7):934-943
pubmed: 32167524
Toxicol Appl Pharmacol. 2018 Jun 15;349:83-93
pubmed: 29679655
Clin Ther. 2000 Feb;22(2):209-21
pubmed: 10743980
Lancet Respir Med. 2020 Apr;8(4):e21
pubmed: 32171062
Pharmacol Ther. 2014 Feb;141(2):150-9
pubmed: 24080471
Antiviral Res. 2018 Feb;150:202-216
pubmed: 29325970
Lancet. 2020 Feb 15;395(10223):507-513
pubmed: 32007143
Crit Care. 2018 Mar 23;22(1):80
pubmed: 29566734
Lancet Respir Med. 2020 May;8(5):475-481
pubmed: 32105632
J Manag Care Spec Pharm. 2017 Mar;23(3-b Suppl):S5-S16
pubmed: 28287346
Pharmacol Res. 2019 Aug;146:104332
pubmed: 31254666
Ther Adv Respir Dis. 2012 Jun;6(3):127-35
pubmed: 22361928
Daru. 2014 Jul 15;22:57
pubmed: 25027749
Front Neurol. 2018 Jan 15;8:744
pubmed: 29387038
Medicine (Baltimore). 2016 May;95(19):e3629
pubmed: 27175674