ArticleMedical hypotheses2020
N-Acetylcysteine: A potential therapeutic agent for SARS-CoV-2.
Article in Medical hypotheses, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 68 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
68 citing papers in PubMed, 132 citations in OpenAlex.
- N-acetylcysteine as an adjunct therapy ameliorates oxidative stress and attenuates anaemia, acute phase response and hepatic injury in clinical Babesia gibsoni infection in dogs-a pilot study.Molecular biology reports · 2026Article
- Porcine Epidemic Diarrhea-Virus-Induced Cell Death: Mechanistic Insights and Therapeutic Strategies.Veterinary sciences · 2025Review
- Neuropsychiatric Manifestations of COVID-19 Disease and Post COVID Syndrome: The Role of N-acetylcysteine and Acetyl-L-carnitine.Current neuropharmacology · 2025Review
- Clinical efficacy of N-acetylcysteine for COVID-19: A systematic review and meta-analysis of randomized controlled trials.Heliyon · 2024Article
- N-Acetylcysteine Treats Spinal Cord Injury by Inhibiting Astrocyte Proliferation.Analytical cellular pathology (Amsterdam) · 2024Article
- Evaluation of the efficacy and safety of oral N-acetylcysteine in patients with COVID-19 receiving the routine antiviral and hydroxychloroquine protocol: A randomized controlled clinical trial.Immunity, inflammation and disease · 2023Article
- Pharmacogenomic Landscape of Ivermectin and Selective Antioxidants: Exploring Gene Interplay in the Context of Long COVID.International journal of molecular sciences · 2023Article
- N-Acetylcysteine and Its Immunomodulatory Properties in Humans and Domesticated Animals.Antioxidants (Basel, Switzerland) · 2023Review
- Antidotes in Clinical Toxicology-Critical Review.Toxics · 2023Review
- Ongoing oxidative stress in individuals with post-acute sequelae of COVID-19.NeuroImmune pharmacology and therapeutics · 2023Article
- N-acetylcysteine reduces severity and mortality in COVID-19 patients: A systematic review and meta-analysis.Journal of advanced veterinary and animal research · 2023Article
- Glutathione for Food and Health Applications with Emphasis on Extraction, Identification, and Quantification Methods: A Review.Metabolites · 2023Review
- Therapeutic role of N-acetyl cysteine (NAC) for the treatment and/or management of SARS-CoV-2-induced lung damage in hamster model.European journal of pharmacology · 2023Article
- Can circulating oxidative stress-related biomarkers be used as an early prognostic marker for COVID-19?Frontiers in medicine · 2023Article
- Protective role of N-acetylcysteine and Sulodexide on endothelial cells exposed on patients' serum after SARS-CoV-2 infection.Frontiers in cellular and infection microbiology · 2023Article
- N-acetylcysteine as adjuvant therapy for hospitalized Covid-19 patients: A single-center prospective cohort study.Caspian journal of internal medicine · 2023Article
- Long COVID: mechanisms, risk factors and recovery.Experimental physiology · 2023Review
- N-acetylcysteine Reduces Inflammasome Activation Induced by SARS-CoV-2 Proteins In Vitro.International journal of molecular sciences · 2022Article
- Delineating the SARS-CoV-2 Induced Interplay between the Host Immune System and the DNA Damage Response Network.Vaccines · 2022Review
- Anti-inflammatory effects of N-Acetylcysteine and Elaeagnus angustifolia extract on acute lung injury induced by λ-carrageenan in rat.Inflammopharmacology · 2022Article
8 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
COVID-19, a respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), continues to spread across the globe. Predisposing factors such as age, diabetes, cardiovascular disease, and lowered immune function increase the risk of disease severity. T cell exhaustion, high viral load, and high levels of TNF-ɑ, IL1β, IL6, IL10 have been associated with severe SARS-CoV-2. Cytokine and antigen overstimulation are potentially responsible for poor humoral response to the virus. Lower cellular redox status, which leads to pro-inflammatory states mediated by TNF-ɑ is also potentially implicated. In vivo, in vitro, and human clinical trials have demonstrated N-acetylcysteine (NAC) as an effective method of improving redox status, especially when under oxidative stress. In human clinical trials, NAC has been used to replenish glutathione stores and increase the proliferative response of T cells. NAC has also been shown to inhibit the NLRP3 inflammasome pathway (IL1β and IL18) in vitro, and decrease plasma TNF-ɑ in human clinical trials. Mediation of the viral load could occur through NAC's ability to increase cellular redox status via maximizing the rate limiting step of glutathione synthesis, and thereby potentially decreasing the effects of virally induced oxidative stress and cell death. We hypothesize that NAC could act as a potential therapeutic agent in the treatment of COVID-19 through a variety of potential mechanisms, including increasing glutathione, improving T cell response, and modulating inflammation. In this article, we present evidence to support the use of NAC as a potential therapeutic agent in the treatment of COVID-19.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.