Open AccessImportance of antiviral H₂S in treatment protocols for COVID-19
Author(s) -
Ed. J. van Hezik
Publication year - 2021
Publication title -
pulʹmonologiâ
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.126
H-Index - 6
eISSN - 2541-9617
pISSN - 0869-0189
DOI - 10.18093/0869-0189-2021-31-5-636-644
Subject(s) - covid-19 , medicine , clinical trial , antiviral therapy , pneumonia , regimen , antiviral treatment , antiviral drug , virus , virology , intensive care medicine , immunology , disease , infectious disease (medical specialty) , chronic hepatitis
Aim. To propose a new type of antiviral treatment for COVID-19, pending the rollout of the developed vaccines and bypassing vaccine resistance of the new upcoming mutated virus variants. Aiming for prophylaxis and early therapy, the search focused on small molecules or repurposed, safe, oral and inexpensive drugs, also suitable for low-income countries. Methods. A search in peer-reviewed literature for preclinical antiviral mechanisms highlighted at last two clinical studies for further detailed clinical analysis: 1) High dose N-acetylcysteine (NAC) was successfully applied in very severe COVID-19-pneumonia; 2) The discovery of serum level H 2 S (hydrogen sulfide) as a prognostic host factor. Results. Combining of these two findings resulted in a step-by-step approach with 3 perspectives that describes how H 2 S works in viral respiratory diseases, how H 2 S targets at least three vulnerabilities in the SARS-CoV-2 virus; finally, how H 2 S can be generated and with which drugs. More than 3 dozen successful, clinically well-documented applications have already been found. Conclusion. By using NAC as the H 2 S donor, the generated endogenous antiviral H 2 S reactivates the collapsed innate immunity, providing a therapy regimen for COVID-19. Further randomized controlled trials are warranted, considering antiviral H 2 S for inclusion in some master trial protocols.