I am not a clinician but this could do some work from my point of view and is widely available.

Article Treatment with N-acetylcysteine plus deferoxamine protects r...

May be.....below mentioned literatures support it...but to verify, research study is demanded for appropriateness in case of COVID-19.

1. Mata M et al.

2. Geiler J, Michaelis M, Naczk P, et al. N-acetyl-L-cysteine (NAC) inhibits virus replication and expression of pro-inflammatory molecules in A549 cells infected with highly pathogenic H5N1 influenza A virus. Biochem Pharmacol. 2010;79(3):413–420.

It might be a good idea for two reasons. (1) to thin the mucus in lungs, and (2) there is new evidence that the virus might result in oxidative stress via hemoglobin damage and iron liberation. NAC will provide more GSH to possibly counteract this oxidative stress.

yes وWe are conducting a clinical trial with a dose of NAC 1200 mg, although with a high dose of vitamin C and has been effective so far.

Yes, my wife is at the highest risk! Because she has Pulmonary Hypertension (Pulmonary Capillary Hemangiomatosis) and I had already been using 1200 mg of NAC experimentally to prevent the fibrotic process of Hemangiomatosis. However, it ended up becoming contaminated and in the last few days I ended up performing pcr to rule out the hypothesis and ended up confirming positive for SARS COV2. And despite the high risk of her illness she managed to overcome COVID.

I am in a task force composed of doctors, virologist and the like. I am more the data guy than anything else; so take my word as is. But, following Adam L Vanwert hypothesis, we have our own hypothesis that a combo of Bromhexine and NAC could target both pathways of the oxidative stress. With Bromhexine you could target the TMPRSS2 [1] and with NAC you attack the other side of the equation providing GSH to counteract what oxidative stress you already have in place and the trombogenesis. So, essentially, you are doing a double nelson on the super oxides [2]. Luckily we still dont have COVID reported cases to treat; but we are waiting for the IgG results of a potential case back in February that we discovered yesterday by chance (friend of mine) that had come from Montreal where he had a meeting with a Chinese national that had also travelled there. Felt pretty bad for a week and had everything that would give you a suspicion of COVID infection (upper chest rash, dry cough, muscle pain, headaches and diarrea) but without the fever (which at the time was part of the required protocol and Canada was not in our 'warning list'). He was given Bromhexine for the dry cough and the symphtoms disapeer in 2 days.

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7175911/

[2] https://youtu.be/Dr_6w-WPr0w?t=1478

May combat conditions of oxidative stress.Serves as a substrate for the synthesis of glutathione (GSH) in the body which an antioxidant effect.

May had anticoagulants effect

Also week antiviral effects

So, may be beneficial !!

It is interesting to note that all COVID19 underlying comorbidities exhibit glutathione deficiency (literature review). The theory that the virus causes complete depletion in patients requiring ventilation is plausible for a number of reasons.

GSH depletion causes rapid accumulation of free radicals (e.g.superoxides) in addition to that of other endogenous and exogenous toxins. The outcome is essentially sepsis and resultant cytokine storm (https://www.researchgate.net/publication/317276353_Cytokine_storm_and_sepsis_disease_pathogenesis).

Environmental factors like pollution, nutrition, food contam with mycotoxins etc. therefore play a role in the exacerbation of COVID 19 disease outcomes.

So yes NAC and alpha lipoic acid could potentially prevent outcomes and improve outcomes in serious cases. Worth exploring.

I have been taking NAC along with vitamin D and a super healthy diet for some months and am feeling very fit - afaik have not been exposed to COVID 19 but have been exposed to Medcram and Drbeen educational videos and come to my own conclusions. For someone who has had an annoyingly clogged and wheezy chest all my life I'm wishing someone had got me onto NAC about 60 years ago (sinus scrape out was in vogue back then - useless waste of time and resources). But hey, I now have a much less troubling breathing condition whether or not it helps me in other ways in future :) - I am very very happy with this discovery.

The presence of the protective molecule, glutathione, in the blood varies three-fold from individual to individual(1). The oxidized (spent) form varies up to 80 fold(2). Scientists do not know the reason for this. My own research shows one potential explanation for this variability, and that is an unappreciated toxicity due to common pesticides in our diets. The type of toxicity we are tracking tends to not directly kill human beings, but it leaves their immune systems extremely vulnerable to subsequent stresses (like the current pandemic).

The work by Polonikov from Russia (3) shows correlation between those with depleted glutathione and those with the most severe outcomes from covid-19 infection. Polonikov himself now heartily recommends dietary supplementation with NAC (N-acetyl cysteine) to correct basal levels of glutathione present in the liver and the bloodstream, with heavier supplementation after symptoms of covid-19 manifest.

1- Blood glutathione concentrations in a large-scale human study. J P Richie Jr 1, L Skowronski, P Abraham, Y Leutzinger. Clin Chem 1996 Jan;42(1):64-70.

2- Glutathione disulfide variability in normal human blood. B J Mills 1, J P Richie Jr, C A Lang Anal Biochem 1994 Oct;222(1):95-101.

3- Endogenous Deficiency of Glutathione as the Most Likely Cause of Serious Manifestations and Death in COVID-19 Patients Alexey Polonikov ACS Infectious Disease 2020 May 28.

Please kindly be aware of the papers of Prof Robert Click, he would be happy to contact with researchers to test the compound clinically

Robert Click [email protected]Article Potential alteration of COVID-19 by beta-mercaptoethanol

the compound may at least reverse some immunosuppression (MDSC induced CD4+ lymphocyte failure) related to COVID.

Here's my take on COVID - the "dry cough" reflects abundant bronchial mucus that is "too thick to move". See Early Wuhan autopsy series. Many complications can be traced back to inspissated mucus - a concentrated "toxic soup" of viruses (live and dead), inflammatory cells and cytokines overflowing from the bronchial mucosa.

Providers' concern re: transmission of infection (understandable) leads to patients cough suppression - good for reducing transmission but bad for the patient.

When I have coached my COVID patients "strategic coughing" in isolation, they universally report "I had no idea there was so much mucus in my chest"

Is anyone exploring interventions to actually promote mucus clearance? Encourage cough? nebulizers w albuterol? nebulizers with NAC? HFNC?

Sorry this is so long.