Current studies are investigating the clinical safety and efficacy of NAC in COVID-19 patients.  One hopes to decrease the dependency of hospitalized COVID-19 patients on ventilators by treating patients with nebulized NAC and heparin.  Another is quantifying clinical improvement in COVID-19 patients who received 6 g/day of intravenous NAC as well as other prescribed treatments.  An oral NAC dose of 600 mg/day may have protective effects against a SARS-CoV-2 infection.  These proposed treatment methods have yet to be fully tested.

Michigan State University

N-acetylcysteine (NAC) thins mucus as a mucolytic because of its its free sulfhydryl group which reduces disulfide bonds in mucus glycoproteins.  Additionally, it is a strong antioxidant.  NAC may be beneficial in treating or preventing SARS-CoV-2 infections in the following ways:

- NAC may be able to cleave SARS-CoV-2 E protein which would decrease its infectivity
- NAC has been shown to decrease angiotensin II bonds to angiotensin II type 1 receptors in vitro
- NAC has been shown to block ACE activity and limit the amount of Ang II both in vitro and clinically 
- NAC may be able to counteract the reactive oxygen species (ROS) produced by cytokine storm syndrome
- NAC has been shown to restore platelet GSH reserves and prevent protein glycosylation, a pathological mechanism of COVID-19 in diabetic patients
- NAC has been shown to inhibit NF-κB activation in an in vitro influenza (A and B) model which mediates COVID-19 pathology in the lungs by initiating the production of pro-inflammatory cytokines


Using N-acetylcysteine to Treat or Prevent COVID-19

Jorge-Aarón, R. M., & Rosa-Ester, M. P. (2020). N-acetylcysteine as a potential treatment for novel coronavirus disease 2019.
https://www.futuremedicine.com/doi/full/10.2217/fmb-2020-0074
doi: 10.2217/fmb-2020-0074

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