ArticleClinical immunology (Orlando, Fla.)2020
Therapeutic blockade of inflammation in severe COVID-19 infection with intravenous N-acetylcysteine.
Article in Clinical immunology (Orlando, Fla.), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 72 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
72 citing papers in PubMed, 148 citations in OpenAlex.
- Response to Intravenous N-Acetylcysteine Supplementation in Critically Ill Patients with COVID-19.Nutrients · 2023Trial
- Evaluating the effect of Edaravone on clinical outcome of patients with severe COVID-19 admitted to ICU: a randomized clinical trial.Inflammopharmacology · 2022Trial
- A pilot study on intravenous N-Acetylcysteine treatment in patients with mild-to-moderate COVID19-associated acute respiratory distress syndrome.Pharmacological reports : PR · 2021Trial
- Decreased Plasma Concentration of Hydrogen Sulfide in Hospitalized COVID-19 Patients: A Novel Determinant of Mortality?Antioxidants (Basel, Switzerland) · 2026Article
- Development of an inhalable dry powder formulation for inhibition of SARS-CoV-2.International journal of pharmaceutics: X · 2025Article
- Redox Regulation of Microvascular Physiology and Pathophysiology: Insights into Therapeutic Strategies and Limitations.Antioxidants & redox signaling · 2025Review
- Metabolic Reprogramming in Respiratory Viral Infections: A Focus on SARS-CoV-2, Influenza, and Respiratory Syncytial Virus.Biomolecules · 2025Review
- N-Acetylcysteine in the Treatment of Acute Lung Injury: Perspectives and Limitations.International journal of molecular sciences · 2025Review
- N-acetylcysteine (NAC) supplementation improves dyspnea and may normalize von Willebrand plasma levels in gynecologic patients with Post-Acute-COVID-Sequela (PASC)/Long COVID.Gynecologic oncology reports · 2025Article
- The role of reactive oxygen species in severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection-induced cell death.Cellular & molecular biology letters · 2024Review
- N-acetyl Cysteine Overdose Induced Acute Toxicity and Hepatic Microvesicular Steatosis by Disrupting GSH and Interfering Lipid Metabolisms in Normal Mice.Antioxidants (Basel, Switzerland) · 2024Article
- Associations between COVID-19 and Glucose-6-Phosphate Dehydrogenase Activity in Brazil.The American journal of tropical medicine and hygiene · 2024Article
- Exploring the Interplay of Food Security, Safety, and Psychological Wellness in the COVID-19 Era: Managing Strategies for Resilience and Adaptation.Foods (Basel, Switzerland) · 2024Review
- Precision nutrition to reset virus-induced human metabolic reprogramming and dysregulation (HMRD) in long-COVID.NPJ science of food · 2024Review
- Clinical efficacy of N-acetylcysteine for COVID-19: A systematic review and meta-analysis of randomized controlled trials.Heliyon · 2024Article
- Signaling pathways and potential therapeutic targets in acute respiratory distress syndrome (ARDS).Respiratory research · 2024Review
- 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
- N-Acetylcysteine and Its Immunomodulatory Properties in Humans and Domesticated Animals.Antioxidants (Basel, Switzerland) · 2023Review
- Intravenous N-Acetylcysteine in Management of COVID-19: A Case Series.Journal of pharmacy practice · 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
12 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
9 authors at 2 institutions in 1 country.
Funding
Abstract
Glucose 6-phosphate dehydrogenase (G6PD) deficiency facilitates human coronavirus infection due to glutathione depletion. G6PD deficiency may especially predispose to hemolysis upon coronavirus disease-2019 (COVID-19) infection when employing pro-oxidant therapy. However, glutathione depletion is reversible by N-acetylcysteine (NAC) administration. We describe a severe case of COVID-19 infection in a G6PD-deficient patient treated with hydroxychloroquine who benefited from intravenous (IV) NAC beyond reversal of hemolysis. NAC blocked hemolysis and elevation of liver enzymes, C-reactive protein (CRP), and ferritin and allowed removal from respirator and veno-venous extracorporeal membrane oxygenator and full recovery of the G6PD-deficient patient. NAC was also administered to 9 additional respirator-dependent COVID-19-infected patients without G6PD deficiency. NAC elicited clinical improvement and markedly reduced CRP in all patients and ferritin in 9/10 patients. NAC mechanism of action may involve the blockade of viral infection and the ensuing cytokine storm that warrant follow-up confirmatory studies in the setting of controlled clinical trials.
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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.