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Identification of druggable host dependency factors shared by multiple SARS-CoV-2 variants of concern 
Ilaria Frasson1,† , Linda Diamante1,2,† , Manuela Zangrossi1,† , Elena Carbognin2 , Anna Dalla Pietà3 , Alessandro Penna3 , Antonio Rosato3,4 , Ranieri Verin5 , Filippo Torrigiani5 , Cristiano Salata1 , Marìa Paula Dizanzo1 , Lorenzo Vaccaro6,7 , Davide Cacchiarelli6,7,8 , Sara N. Richter1,9,* , Marco Montagner1,* , Graziano Martello2,*
1Department of Molecular Medicine, University of Padua, Padua 35121, Italy
2Department of Biology, Armenise/Harvard Pluripotent Stem Cell Biology Laboratory, University of Padua, Padua 35131, Italy
3Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua 35128, Italy
4Veneto Institute of Oncology IOV-IRCCS, Padua 35128, Italy
5Department of Comparative Biomedicine and Food Science, University of Padua, Padua 35020, Italy
6Telethon Institute of Genetics and Medicine (TIGEM), Armenise/Harvard Laboratory of Integrative Genomics, Pozzuoli 80078, Italy
7Department of Translational Medicine, University of Naples Federico II, Naples 80138, Italy
8School for Advanced Studies, Genomics and Experimental Medicine Program, University of Naples Federico II, Naples 80138, Italy
9Microbiology and Virology Unit, Padua University Hospital, Padua 35128, Italy
These authors contributed equally to this work
*Correspondence to:Sara N. Richter , Email:sara.richter@unipd.it Marco Montagner , Email:marco.montagner@unipd.it Graziano Martello , Email:graziano.martello@unipd.it
J Mol Cell Biol, Volume 16, Issue 3, March 2024, mjae004,  https://doi.org/10.1093/jmcb/mjae004
Keyword: SARS-CoV-2, variants of concern, host dependency factors, antivirals, N-acetyl cysteine

The high mutation rate of SARS-CoV-2 leads to the emergence of multiple variants, some of which are resistant to vaccines and drugs targeting viral elements. Targeting host dependency factors, e.g. cellular proteins required for viral replication, would help prevent the development of resistance. However, it remains unclear whether different SARS-CoV-2 variants induce conserved cellular responses and exploit the same core host factors. To this end, we compared three variants of concern and found that the host transcriptional response was conserved, differing only in kinetics and magnitude. Clustered regularly interspaced short palindromic repeats screening identified host genes required for each variant during infection. Most of the genes were shared by multiple variants. We validated our hits with small molecules and repurposed the US Food and Drug Administration-approved drugs. All the drugs were highly active against all the tested variants, including new variants that emerged during the study (Delta and Omicron). Mechanistically, we identified reactive oxygen species production as a key step in early viral replication. Antioxidants such as N-acetyl cysteine (NAC) were effective against all the variants in both human lung cells and a humanized mouse model. Our study supports the use of available antioxidant drugs, such as NAC, as a general and effective anti-COVID-19 approach.