Viral pathologies encompass activation of pro-oxidative pathways and inflammatory
burst. Alleviating overproduction of reactive oxygen species and cytokine storm in
COVID-19 is essential to counteract the immunogenic damage in endothelium and alveolar
membranes. Antioxidants alleviate oxidative stress, cytokine storm, hyperinflammation,
and diminish the risk of organ failure. Direct antiviral roles imply: impact on viral
spike protein, interference with the ACE2 receptor, inhibition of dipeptidyl peptidase
4, transmembrane protease serine 2 or furin, and impact on of helicase, papain-like
protease, 3-chyomotrypsin like protease, and RNA-dependent RNA polymerase. Prooxidative
environment favors conformational changes in the receptor binding domain, promoting the
affinity of the spike protein for the host receptor. Viral pathologies imply a vicious
cycle, oxidative stress promoting inflammatory responses, and vice versa. The same was
noticed with respect to the relationship antioxidant impairment-viral replication.
Timing, dosage, pro-oxidative activities, mutual influences, and interference with other
antioxidants should be carefully regarded. Deficiency is linked to illness severity.