AID  Vol.10 No.3 , December 2020
COVID-19 Patient with Multifocal Pneumonia and Respiratory Difficulty Resolved Quickly: Possible Antiviral and Anti-Inflammatory Benefits of Quercinex (Nebulized Quercetin-NAC) as Adjuvant
Abstract: Background: SARS-CoV-2 (COVID-19) is a viral pandemic with no current vaccine or effective treatment. Hydroxychloroquine and azithromycin are not without cardiovascular risk or complications, and these treatments can fail to aid in full recovery from COVID-19. As new treatments become approved for the pandemic, an inexpensive, non-toxic, and safe adjunctive therapy is needed. Case Presentation: A 59-year-old male presented with respiratory symptoms. Chest X-ray revealed classic indications of COVID-19 pneumonia. A PCR nasopharyngeal swab test confirmed a COVID-19 infection and hospital doctors prescribed Rocephin, azithromycin, and hydroxychloroquine. The patient was then prescribed Quercinex, a nebulized formula of quercetin-(cyclodextrin) (20 mg/mL) and N-acetylcysteine (100 mg/mL) three times daily for 14 days by physicians at Envita Medical Center for continued COVID-19 respiratory symptoms. Following 30 minutes after each nebulization treatment, the patient experienced immediate deep breathing relief that lasted for multiple hours. Within the following 48 hours after the first treatment, respiratory symptoms continued to diminish and resolve quickly. Finally, post-treatment follow-up chest X-rays revealed no pulmonary fibrosis (scarring) and clear lung fields. Conclusion: The Quercinex formula appeared to greatly alleviate the unresolved respiratory symptoms rapidly. Several mechanisms of the formula, namely antiviral and anti-inflammatory action, with direct administration via nebulizer to the deep lung tissue, could potentially explain the fast and complete recovery. We recommend that the Quercinex formula be considered for further clinical study as an adjuvant or on its own for COVID-19 and possibly other viral pulmonary conditions.
Cite this paper: Schettig, R. , Sears, T. , Klein, M. , Tan-Lim, R. , Matthias Jr., R. , Aussems, C. , Hummel, M. , Sears, R. , Poteet, Z. , Warren, D. , Oertle, J. and Prato, D. (2020) COVID-19 Patient with Multifocal Pneumonia and Respiratory Difficulty Resolved Quickly: Possible Antiviral and Anti-Inflammatory Benefits of Quercinex (Nebulized Quercetin-NAC) as Adjuvant. Advances in Infectious Diseases, 10, 45-55. doi: 10.4236/aid.2020.103006.

[1]   FDA (2020) FDA Cautions against Use of Hydroxychloroquine or Chloroquine for COVID-19 Outside of the Hospital Setting or a Clinical Trial Due to Risk of Heart Rhythm Problems.

[2]   Ray, W.A., et al. (2012) Azithromycin and the Risk of Cardiovascular Death. New England Journal of Medicine, 366, 1881-1890.

[3]   DA (2016) Pharmacy Compounding of Human Drug Products under Section 503A of the Federal Food, Drug, and Cosmetic Act Guidance.

[4]   World Health Organization (2019) World Health Organization Model List of Essential Medicines: 21st List 2019.

[5]   Vearrier, M.E.D. (2019) N Acetylcysteine.

[6]   Vaidya, B., et al. (2016) Effectiveness of Periodic Treatment of Quercetin against Influenza A Virus H1N1 through Modulation of Protein Expression. Journal of Agricultural and Food Chemistry, 64, 4416-4425.

[7]   Dabbagh-Bazarbachi, H., et al. (2014) Zinc Ionophore Activity of Quercetin and Epigallocatechin-Gallate: From Hepa 1-6 Cells to a Liposome Model. Journal of Agricultural and Food Chemistry, 62, 8085-8093.

[8]   Nair, M.P., et al. (2006) The Flavonoid Quercetin Inhibits Proinflammatory Cytokine (Tumor Necrosis Factor Alpha) Gene Expression in Normal Peripheral Blood Mononuclear Cells via Modulation of the NF-κβ System. Clinical and Vaccine Immunology, 13, 319-328.

[9]   Kandere-Grzybowska, K., et al. (2006) Regulation of IL-1-Induced Selective IL-6 Release from Human Mast Cells and Inhibition by Quercetin. British Journal of Pharmacology, 148, 208-215.

[10]   Huebbe, P., et al. (2010) Effect of Dietary Quercetin on Brain Quercetin Levels and the Expression of Antioxidant and Alzheimer’s Disease Relevant Genes in Mice. Pharmacological Research, 61, 242-246.

[11]   Therapeutic Research Center (2020) Natural Medicines Database, Quercetin.

[12]   Stone, J. (2003) Quercetin Monograph. UC, Denver.

[13]   Multum, C. (2020) Acetylcysteine.

[14]   Uraz, S., et al. (2013) N-Acetylcysteine Expresses Powerful Anti-Inflammatory and Antioxidant Activities Resulting in Complete Improvement of Acetic Acid-Induced Colitis in Rats. Scandinavian Journal of Clinical & Laboratory Investigation, 73, 61-66.

[15]   Friday, E., Bhanderi, N. and Turturro, F. (2010) Effect of Antioxidant N Acetylcysteine Treatment on the Phenotype of the TCL 1 Transgenic Mouse Model of B CLL through Reactive Oxygen Species (ROS) Modulation. Blood, 116, 1475-1475.

[16]   Guerrero, C.A., Murillo, A. and Acosta, O. (2012) Corrigendum to “Inhibition of Rotavirus Infection in Cultured Cells by N-acetyl-cysteine, PPARγ Agonists and NSAIDs” [Antiviral Research 96(1) (2012) 1-12]. Antiviral Research, 96, 269.

[17]   Sreekanth, G.P., et al. (2019) Drug Repurposing of N-acetyl Cysteine as Antiviral against Dengue Virus Infection. Antiviral Research, 166, 42-55.

[18]   DA (2016) Acetylcysteine

[19]   Kurkov, S.V. and Loftsson, T. (2013) Cyclodextrins. International Journal of Pharmaceutics, 453, 167-180.

[20]   Kelly, G.S. (2011) Quercetin. Monograph. Alternative Medicine Review: A Journal of Clinical Therapeutic, 16, 172-194.

[21]   Hamming, I., et al. (2004) Tissue Distribution of ACE2 Protein, the Functional Receptor for SARS Coronavirus. A First Step in Understanding SARS Pathogenesis. The Journal of Pathology, 203, 631.

[22]   Hoffman, H.N., Phyliky, R.L. and Fleming, C.R. (1988) Zinc-Induced Copper Deficiency. Gastroenterology, 94, 508-512.

[23]   Willis, M.S., et al. (2005) Zinc-Induced Copper Deficiency: A Report of Three Cases Initially Recognized on Bone Marrow Examination. American Journal of Clinical Pathology, 123, 125-131.