N-Acetylcysteine, Immunity and Perspectives in covid-19: A Narrative Review of the Literature

Introduction: N-acetylcysteine (NAC) is one of the drugs that has been proposed in the management of covid-19, this drug has more than 50 years of use in prophylaxis and therapy of several conditions. Objective: To conduct a literature review to collect available evidence on the use of NAC as an adjuvant in immunization and treatment of COVID-19, as well as on its use in other RNA viruses' infections. Methods: We searched Medline and clinicaltrials.gov with the key terms "n-acetyl cysteine", "COVID-19" and "vaccination". Included references were screened for additional relevant papers. Results: The search retrieved 151 references and after screening, 42 were included. Included references included evidence on the theoretical approaches, results of clinical studies and basic experimentation that describe the use of NAC in treatment, prevention of COVID-19, as well as on the mechanisms of action, use, efficacy and safety in this and other infections caused by RNA viruses. Conclusions: the administration of NAC could improve certain clinical outcomes in COVID-19. Additional clinical trials are required to investigate its effectiveness in patients with COVID-19 or during vaccination.