This article was previously published on August 14, 2020 and has been updated with new information.
Coronaviruses were identified in the mid-1960s and named after crown-like spikes on the cell surface. Until the arrival of the first SARS-CoV in 2003, there were four common coronaviruses.1 The CDC’s list of symptoms for these viruses shows that they are the same as for the common cold.2 These include runny nose, sore throat, headache, fever and cough.
However, from what scientists have discovered since the onset of the global pandemic, symptoms and long-term effects are far different for SARS-CoV-2. Initial symptoms include fever, cough, shortness of breath, fatigue, and loss of taste or smell.3 But unlike natural coronavirus, additional complications can affect the cardiovascular system, kidneys, liver and lungs.4
One of the identified underlying dysfunctions that cause shortness of breath and severe pulmonary complications is hypercoagulability. In one study, patients admitted to the University Hospital of Padua in Italy due to acute respiratory failure showed “highly hypercoagulable thromboelastometry profiles.” The researchers said:5
“In conclusion, patients with COVID-19 with acute respiratory failure have severe hypercoagulability rather than consumer coagulopathy. Fibrin formation and polymerization may predispose to thrombosis and correlate with poorer outcome.”
Whole-body clot formations may be associated with other complications that occur after disease withdrawal. It seems that the difference between people who have a mild or severe disease may be related to the body’s ability to reduce hypercoagulability and the hyperimmune response that leads to a cytokine storm.
How does glutathione work – ‘Myaslan antioxidant?’
An antioxidant is a molecule that prevents other molecules from oxidizing. Glutathione is a powerful antioxidant that can play a significant role in the COVID-19 disease process. There are 20 amino acids that can combine into different formations to form a protein molecule.6
However, glutathione is a tripeptide, which means that there are only three amino acids that line up in the glutathione molecule. These are cystine, glycine and glutamate. Together, they help use and recycle other antioxidants, such as vitamin C and CoQ10.7,8
This means that your body uses glutathione to increase the effectiveness of these antioxidants and helps recycle molecules. Without glutathione, antioxidant capacity is significantly reduced. This function may be what earned glutathione the “major antioxidant.”9
N-acetylcysteine (NAC) plays the role of glutathione precursor.10 Clinical evidence has also shown effects of NAC, regardless of its role with glutathione, including a thrombolytic effect. It also improves oxidative stress and the inflammatory response.11,12,13,14
In late March 2020, a medical student put this theory to the test when his mother, 48-year-old Josephine Bruzzese, was diagnosed with pneumonia at NYU Langone Hospital in Brooklyn. Without a test available on COVID-19, they sent her home as a suspect. She was prescribed hydroxychloroquine and azithromycin, which helped improve some symptoms but not her breathing.
When she couldn’t stand and had severe respiratory problems,15 her son contacted Dr. Richard Horowitz, an expert who was treating his sister for Lyme disease, who suggested using glutathione to reduce inflammation and protect Bruzzese’s lung tissue. The results were dramatic.
Within one hour after receiving a dose of 2000 mg of glutathione, she breathed better and was able to stand. She continued to take glutathione for five days and had no relapse. Speaking to a New York Post reporter, Horowitz said he is working on devising an extensive clinical trial to prove the effectiveness of what he calls “a simple treatment that is not expensive.”
On May 5, 2020, the Memorial Sloan Kettering Cancer Center published a study on Clinicaltrials.gov announcing a study involving the use of NAC in patients with COVID-19. In this first study of its kind, the research team plans to include patients with severe disease: one group in the study will receive 6 grams of NAC intravenously each day along with other treatments.16
Scientists claim the deficiency is linked to severe COVID-19
Around the same time the study was announced by Memorial Sloan Kettering, a Russian scientist published papers suggesting that glutathione plays a key role in a person’s ability to respond to COVID-19 infection and consequent disease severity.17,18,19 In this short video, Dr. Roger Seheult explains science.
In addition, Dr. Alexey Polonikov, of the Kursk State Medical University, theorizes that glutathione can be used as a disease prevention and treatment. Polonikov studies human molecular genetics and oxidative stress.20
Based on an exhaustive analysis of the literature he conducted, he later said he believed glutathione deficiency was a likely cause of serious illness with COVID-19:21
(1) oxidative stress contributes to hyper-inflammation of the lungs leading to detrimental disease outcomes such as acute respiratory distress syndrome, multiple organ failure, and death;
(2) weak antioxidant defenses due to lack of endogenous glutathione due to decreased biosynthesis and / or increased depletion of GSH is the most likely cause of increased oxidative lung damage, regardless of which of the aging factors, chronic disease comorbidities, smoking or others were responsible for this deficiency. “
As Polonikov writes22 and Seheult describes in the video, oxidative damage to reactive oxygen species (ROS) plays a significant role in severe disease with COVID-19. In another video, Seheult explains how COVID-19 sets the stage for a significant increase in oxidative stress by increasing superoxide, a harmful ROS.23
It is important that it raises superoxide in people who start with high levels due to chronic diseases such as heart disease, diabetes and high blood pressure. As the virus uses the enzyme ACE2, it produces angiotensin II, which in turn produces more superoxide.
The virus also attracts a type of neutrophil (polymorphonuclear leukocytes) that can also increase superoxide production. The superoxide then produces other hydroxyl radicals, including hydrogen peroxide (H2O2).
These ROS, which cause cell damage, can be reduced by glutathione peroxidase because it oxidizes glutathione in the process of reducing H2O2 to water. As you can see, a lack of glutathione would create an accumulation of ROS as described by Polonikov.
Comorbid risk factors associated with glutathione deficiency
Antioxidant defense against ROS damage is crucial for whole body homeostasis. Polonikov believes that the higher rate of severe viral diseases in older adults and those with comorbidities suggests that there are related biological processes that make these specific individuals more susceptible. It says:24
“In particular, disturbed redox homeostasis and associated oxidative stress appear to be important biological processes that may explain increased individual susceptibility to various environmental insults.”
In one evaluation of COVID-19 patients from six Atlanta hospitals, researchers found independent factors that increased the risk of hospitalization. These include smoking, type 2 diabetes, being male, being black, being elderly and obese.25 Polonikov found evidence that glutathione deficiency may be implied in these comorbidities.
In his work he identifies a progressive decrease in endogenous glutathione with aging. This, he believes, makes “older people more vulnerable to oxidative damage caused by various environmental factors compared to younger people”.26 He points out that endogenous glutathione deficiency is also found in people who have other comorbid conditions.
He suggests that these reduced levels with chronic disease could start a shift toward oxidative stress and worsen pneumonia, ultimately leading to “acute respiratory distress syndrome (ARDS), multiple organ failure, and death”.27 Some men and some smokers also have lower levels of glutathione, which increases their risk.
In another ongoing study on the genetics of redox homeostasis and type 2 diabetes, four patients in the control group became infected with COVID-19. Blood samples were collected and used to measure ROS and glutathione levels.28
All four were non-smokers without chronic disease who had a confirmed positive PCR test. In cases of individuals who recovered rapidly, the ROS-a-glutathione ratio was 2.075–0.712 or less.
In patients with more significant disease, the ratio was 3.677 to 0.531 in one patient and as high as 2.73 to 0.079 in another. In the first patient with significant disease, this ratio was more than twice as high as in patients who recovered quickly. In the second patient, the ratio was more than 11 times higher.
Relationship between glutathione and vitamin D.
As for vitamin D, Polonikov suggests that the relationship between vitamin D and severe disease may have more to do with glutathione deficiency. He points to several studies linking glutathione levels to vitamin D29,30 and another in which scientists found that lower levels of l-cysteine, a precursor to glutathione, correlated with lower levels of vitamin D in people with type 2 diabetes.31
In a recent animal study, researchers also examined whether glutathione deficiency could cause changes that disrupt vitamin D metabolism.32 They found that deficiency can alter biosynthesis and explained the mechanism of vitamin D deficiency that occurs with glutathione deficiency.
Researchers suggest that there is a potential benefit of glutathione supplementation to reduce vitamin D deficiency. Polonikov writes that this study provides information on the importance of glutathione in controlling endogenous vitamin D biosynthesis and shows the benefits of treatment in reducing vitamin D deficiency.
I believe that both nutrients are vital for protection against serious diseases. Although a lack of glutathione can affect your ability to synthesize vitamin D, this is only applicable when you have enough sun exposure or supplements to raise vitamin D levels.
However, we know that it is difficult to get enough sun in the northern hemisphere, especially during the winter months. In addition, most people use large amounts of sunscreen or avoid the sun altogether, which can exacerbate the deficiency problem.
Strategies to support optimal glutathione levels
Your glutathione levels can be optimized through food, dietary supplements and exercise. Polonikov believes that NAC taken orally can be a preventative strategy that helps maintain your levels. In his work he concluded:33
“Therefore, oral administration of N-acetylcysteine as a preventive measure against viral infections as well as intravenous injection of NAC or reduced glutathione (GSH is highly bioavailable) in patients with serious disease may be effective options against new coronavirus SARS-CoV-2 infections. “
As he says in the video, Seheult believes the damage from COVID-19 is more than oxidative stress.34 He points out that clots removed in patients with confirmed COVID are rich in platelets, which indicates another mechanism that includes disulfide bonds. He goes on to explain:35
“And, as we talked about N-acetylcysteine and reduced glutathione, it will break those disulfide bonds and cause their lysis and potentially alleviate obstruction and hypoxemia with COVID-19. Again, this is all a hypothesis, but it seems to fit.” “
Foods that have had a positive impact on glutathione production include cruciferous vegetables such as broccoli, green tea, curcumin, rosemary and milk thistle.36 Quality sleep can also help.37,38
Different types of exercise can affect your level. In one study, researchers included 80 healthy but sedentary volunteers to measure the type of exercise that could have the greatest impact.39 They found that aerobic training combined with weight training was the greatest benefit.