Cumpstey et al. (Antioxid Redox Signal 2021;10.1089/ars.2021.0017) have thoroughly reviewed the changes to the redox biology that determine individual resilience against COVID-19, and that hint at future treatment regimes. Verd and Verd question whether paracetamol, in the words of Cumpstey et al., "has the potential to overwhelm the body's ability to cope and maintain homeostasis" in COVID-19 patients. In response to this letter, the authors of Cumpstey et al. (Feelisch, Cumpstey, Clarka, Santolinic, and Jacksondargue) argue that what matters for human resilience against SARS-CoV-2 and other stressors is not simply determined by what is ingested/inhaled but also by how these substances can be handled by the body. The ability to cope with competing demands is determined by the extent to which the building blocks essential for cell/organ protection, function, adjustment, and healing can continue to be made available in sufficient quantities. To this end, dietary quality and nutrient status are fundamental determinants of the metabolic background against which all of these factors (including over-the-counter medications such as paracetamol) operate and either support or compromise the balanced functioning of the reactive species interactome.
Keywords: COVID-19; Down syndrome; glutathione; oxidative stress; paracetamol.