COVID-19: oxidative stress and the relevance of antioxidant therapy

Abstract

The emergence of viral respiratory pathogens with high pandemic potential, such as the SARS-CoV-2, poses a serious public health problem, with a very limited arsenal of effective tools and techniques to prevent and treat a new pandemic infection. The literature on the involvement of reactive oxygen species in the pathogenesis of coronavirus infections and the potential for antioxidant therapy was reviewed. Because of available evidence on the involvement of oxidative stress in the mechanisms of initiation and maintenance of homeostasis disorders in SARS-CoV-2, approaches combining reduction of ROS synthesis, inhibition of virus replication, anti-inflammatory action, reduction of hypoxia, and reduction of the toxic effects of drug therapy may be very effective. The hypothesis of the expediency of treating systemic inflammation aimed at "quenching" the cytokine "storm", caused largely by the production of reactive oxygen species, seems essential. In this connection, it is pathophysiologically justified to use for prophylactic and therapeutic purposes antioxidant drugs, which have proven themselves on the example of other viral respiratory infections. Thus, the high activity of preparations of vitamin C, N-acetylcysteine, melatonin, quercetin, glutathione, astaxanthin, polyphenols, polyunsaturated fatty acids, etc. was noted. In addition, these drugs effectively protect the vascular wall, which has been proven for a number of cardiovascular diseases and that can be effective in developing with COVID-19 vasculitis. There is a more pronounced combined effect of these drugs, which is already used in treatment protocols for patients with SARS-CoV-2. Special attention should also be paid to the use of antioxidant drugs as a means to reduce the toxic manifestations of antiviral therapy. Thus, the use of drugs with antioxidant activity can be justified and will certainly improve the effectiveness of the fight against the pandemic of new coronavirus infection.