Is Antioxidant Therapy a Useful Complementary Measure for Covid-19 Treatment? An Algorithm for Its Application

Area of Science:

• Virology
• Immunology
• Critical Care Medicine

Background:

• Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) causes coronavirus disease-19 (COVID-19), leading to severe pneumonia and impaired oxygen exchange.
• Viral pathogenesis involves host receptor binding, protease cleavage, and membrane fusion, with SARS-CoV-2 targeting the angiotensin-converting enzyme 2 receptor.
• Comorbidities exacerbate COVID-19 mortality, and the virus-induced inflammatory response, or cytokine storm, is linked to oxidative stress.

Purpose of the Study:

• To discuss the characteristics and mechanism of SARS-CoV-2.
• To correlate the virus's mechanism with comorbidities that increase mortality.
• To propose antioxidant drugs as a therapeutic measure for COVID-19 patients.

Main Methods:

• Review of general characteristics and mechanism of SARS-CoV-2.
• Analysis of the correlation between viral mechanism and comorbidities.
• Discussion of proposed therapeutic measures, focusing on antioxidant drugs.

Main Results:

• Oxidative stress, driven by free radicals from phagocytic leukocytes, exacerbates inflammation and contributes to organ failure in critical illnesses.
• Cytokine storms in COVID-19 may be mediated by oxidative stress.
• Antioxidant therapy has demonstrated benefits in sepsis, acute respiratory distress syndrome (ARDS), and acute lung injury (ALI), including improved oxygenation and reduced mortality.

Conclusions:

• Antioxidant therapy could potentially benefit COVID-19 patients by mitigating oxidative stress and inflammation.
• Evidence from other critical conditions suggests antioxidant therapy can improve clinical outcomes, reduce ventilation time, and lower mortality rates.
• Further investigation into antioxidant therapy for COVID-19 is warranted.