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It is produced either with the aid of NOS enzymes in the NOS-dependent pathway or formed from dietary nitrate in the NOS-independent pathway

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In a single-center, randomized, double-blind, placebo-controlled trial conducted at the Emergency Department of a hospital in Brazil, 140 patients with severe COVID-19 infection and oxyhemoglobin saturation of less than 94% or respiratory rate higher than 24 breaths/minute were randomized to receive N-acetylcysteine 21,000 mg (approximately 300 mg/kg) for 20 hours or dextrose 5% (placebo)