Case Report: Use of hydroxychloroquine and N-acetylcysteine for treatment of a COVID-19 positive patient
Open Access
- 2 June 2020
- journal article
- Published by F1000 Research Ltd in F1000Research
Abstract
There is worldwide concern for lack of specific therapy against the novel Betacoronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This case report presents the results of a pharmacological intervention aimed at modulating the inflammatory effects of coronavirus disease 2019 (COVID-19), in an effort to avoid the use of mechanical ventilation. A COVID-19 positive patient was admitted with multisystem organ dysfunction, including acute respiratory insufficiency, and was treated with a combination of low oral doses of hydroxychloroquine and intravenous N-acetylcysteine (NAC). The combination therapy resulted in noticeable clinical improvement and a quantifiable decrease of several of the inflammatory markers measured, in particular ferritin levels, C-reactive protein (CRP) and lactic acid. He also developed pulmonary embolism (PE) and deep vein thrombosis (DVT), both known side effects of COVID-19 infection. Following thrombolysis and heparinization his clinical evolution continued a positive trend until discharge. The therapeutic approach utilized in this case suggests that early intervention not only decrease acute organ dysfunction but also may decrease the need for mechanical ventilation in COVID-19 positive patients.Keywords
This publication has 18 references indexed in Scilit:
- Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients With Coronavirus Disease 2019 (COVID-19)Clinical Infectious Diseases, 2020
- Endothelial cell infection and endotheliitis in COVID-19The Lancet, 2020
- Pharmacologic Treatments for Coronavirus Disease 2019 (COVID-19)JAMA, 2020
- Pathogenesis of COVID-19 from a cell biology perspectiveEuropean Respiratory Journal, 2020
- Clinical features of patients infected with 2019 novel coronavirus in Wuhan, ChinaThe Lancet, 2020
- Endotracheal intubation results in acute tracheal damage induced by mtDNA/TLR9/NF-κB activityJournal of Leukocyte Biology, 2018
- How Viruses Invade CellsBiophysical Journal, 2016
- A single-arm clinical trial of a 48-hour intravenous N-acetylcysteine protocol for treatment of acetaminophen poisoningClinical Toxicology, 2014
- The ectodomain of Toll-like receptor 9 is cleaved to generate a functional receptorNature, 2008
- Does N-Acetyl-L-Cysteine Influence Cytokine Response During Early Human Septic Shock?Social psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 1998