Therapeutic blockade of inflammation in severe COVID-19 infection with intravenous N-acetylcysteine.
Clin Immunol
; 219: 108544, 2020 10.
Article
en En
| MEDLINE
| ID: mdl-32707089
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.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
1_ASSA2030
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2_ODS3
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4_TD
Problema de salud:
1_doencas_nao_transmissiveis
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1_doencas_transmissiveis
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2_muertes_prematuras_enfermedades_notrasmisibles
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4_pneumonia
Asunto principal:
Neumonía Viral
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Acetilcisteína
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Infecciones por Coronavirus
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Betacoronavirus
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Síndrome de Liberación de Citoquinas
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Deficiencia de Glucosafosfato Deshidrogenasa
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Antioxidantes
Límite:
Adult
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Humans
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Male
Idioma:
En
Revista:
Clin Immunol
Asunto de la revista:
ALERGIA E IMUNOLOGIA
Año:
2020
Tipo del documento:
Article