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35 In light of these properties, we hypothesize that N-acetylcysteine plays a role in the treatment of COVID-19 infection by the following postulated mechanisms of action (Figure 1): Envelope (E) and spike (S) proteins have a triple cysteine structural motif located directly after the E proteins transmembrane domain (NH 2 - L-Cys-A-Y-Cys-Cys-N -COOH) and a similar motif located in the carboxy terminus of the S protein (NH 2 - S-Cys-G-S-Cys-Cys-K -COOH)

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Limitations include small sample sizes, lack of large multi-center trials, all studies from Eastern Europe or Asia

Hydrogen water addresses these limitations through multiple complementary mechanisms: Supporting SOD expression through Nrf2 pathway activation Neutralizing hydroxyl radicals that form when SOD is insufficient Reducing overall oxidative burden to prevent SOD depletion Providing protection in tissues where SOD activity is compromised For individuals with SOD deficiencies, a combined approach may be optimaladdressing nutritional needs for SOD cofactors while using hydrogen water to provide additional antioxidant support through different mechanisms

Hayirli, K

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