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10.1016/j.clim.2020.108544

http://scihub22266oqcxt.onion/10.1016/j.clim.2020.108544
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suck abstract from ncbi


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pmid32707089      Clin+Immunol 2020 ; 219 (ä): 108544
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  • Therapeutic blockade of inflammation in severe COVID-19 infection with intravenous N-acetylcysteine #MMPMID32707089
  • Ibrahim H; Perl A; Smith D; Lewis T; Kon Z; Goldenberg R; Yarta K; Staniloae C; Williams M
  • Clin Immunol 2020[Oct]; 219 (ä): 108544 PMID32707089show ga
  • 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.
  • |Acetylcysteine/*therapeutic use[MESH]
  • |Adult[MESH]
  • |Antioxidants/*therapeutic use[MESH]
  • |Antirheumatic Agents/therapeutic use[MESH]
  • |Betacoronavirus/*pathogenicity[MESH]
  • |Biomarkers/blood[MESH]
  • |C-Reactive Protein/metabolism[MESH]
  • |COVID-19[MESH]
  • |Coronavirus Infections/blood/complications/*drug therapy/virology[MESH]
  • |Cytokine Release Syndrome/blood/complications/*drug therapy/virology[MESH]
  • |Drug Administration Schedule[MESH]
  • |Ferritins/blood[MESH]
  • |Fibrin Fibrinogen Degradation Products/metabolism[MESH]
  • |Glucosephosphate Dehydrogenase Deficiency/blood/complications/*drug therapy/virology[MESH]
  • |Humans[MESH]
  • |Hydroxychloroquine/therapeutic use[MESH]
  • |Inflammation/prevention & control[MESH]
  • |Male[MESH]
  • |Pandemics[MESH]
  • |Pneumonia, Viral/blood/complications/*drug therapy/virology[MESH]
  • |SARS-CoV-2[MESH]


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