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

ABSTRACT: 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.

SUBMITTER: Dominari A

PROVIDER: S-EPMC7995409 | biostudies-literature | 2021 Mar

REPOSITORIES: biostudies-literature

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

Dominari Asimina A Hathaway Iii Donald D Kapasi Abdulhusein A Paul Trissa T Makkar Sarabjot Singh SS Castaneda Valeria V Gara Sirisha S Singh Bishnu Mohan BM Agadi Kuchalambal K Butt Maliha M Retnakumar Varadha V Chittajallu Spandana S Taugir Rahima R Sana Muhammad Khawar MK Kc Manish M Razzack Sarah S Moallem Niala N Alvarez Alina A Talalaev Michael M

World journal of virology 20210301 2

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 ...[more]

PMID: 33816149

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Project description:IntroductionUsing ozone therapy to manage COVID-19 patients has been accompanied by conflicting results in prior studies. Therefore, we aimed to widely assess the effects of ozone as adjuvant therapy in COVID-19 patients.MethodsPubMed, Scopus, Web of Science, Cochrane, ProQuest, Springer, and Sage journals were searched systematically until April 2022. Mortality rate, ICU admission, hospital-length stay, negative PCR, pulmonary, renal, and hepatic functions, as well as inflammatory and blood systems were pooled to compare the efficacy of ozone as adjacent therapy (OZ) and standard treatment (ST). Analyses were run with the random/fixed models, sub-group analysis, funnel plot, and sensitivity analysis using comprehensive meta-analysis (CMA) software version 2.0.ResultsThe results of four randomized clinical trials (RCTs) and four case-control studies with a total of 371 COVID-19 positive patients were analyzed. The OZ group patients had a shorter length of hospital stay (P > 0.05), lower ICU admissions (P > 0.05), and lower mortality rates (P < 0.05) than the ST group cases. After treatment, 41% more COVID-19 patients had negative PCR tests than the ST group (P < 0.05). Serum creatinine and urea levels were not modified in either group (P > 0.05). Moreover, except for albumin serum levels, which decreased significantly in the OZ group, serum bilirubin, ALT, and AST were not modified in either group (P > 0.05). Both arms did not show a decrease in C-reactive protein blood levels (P > 0.05), but the OZ group showed a significant modification in LDH serum levels (P < 0.05). Unlike the d-dimer and WBC serum levels (P > 0.05), platelet levels were increased in the OZ group (P < 0.05). No negative side effects were demonstrated in either group.ConclusionOzone therapy was effective significantly on PCR test and LDH serum levels, as well as mortality based on overall estimation. Concerning the length of hospital stay and ICU admissions, although the results were insignificant, their effect sizes were notable clinically. More RCT studies are needed to show the efficacy of ozone therapy on other studied variables.

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

Publications

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

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