N-acetylcysteine as adjuvant therapy for hospitalized Covid-19 patients: A single-center prospective cohort study
MD Siamak Afaghi, MD Negin Moghimi, Nasser Malekpour, MD Fatemeh Sadat Rahimi, MD Rana Irilouzadian, MD, MPH Farzad Esmaeili Tarki, PhD Morvarid Moghimi, MD Sara Besharat, Hossein Salehi, MD Anita Karimi
doi:10.22088/cjim.14.3.553
Background: Whilst over two years have passed since the COVID-19 pandemic's emergence, the proper management of the disease remains challenging. Nacetylcysteine (NAC) as a potentially effective therapeutic option has been suggested by studies, while the exact clinical role of this agent is yet to be evaluated. Methods: This prospective case-control study was conducted in a major referral respiratory center in Tehran, Iran. We enrolled 217 patients treated with an intravenous daily dose of 1500 mg NAC as a case group; and 245 control patients who did not receive NAC. Two groups were matched based on other treatments, sociodemographics, medical history, and comorbidities. Results: After ten days of adjuvant therapy with NAC, patients in the NAC group and control group had median room-air SpO2 of 91% and 88%, respectively (P=0.02). Also, the SpO2 to FiO2 ratio had a median of 463 and 421 in the case and control groups, respectively (P=0.01). Furthermore, the case group's hospitalization period was three days shorter (P=0.002). Further, cough, dyspnea, and decreased appetite were reported to have a significantly lower incidence in the case group (P=0.03, 0.001, 0.008).
Conclusion: We showed that a daily intravenous dose of NAC in hospitalized COVID-19 patients could shorten the hospital stay and improve some clinical symptoms; however, it does not remarkably improve the risk of ICU admission and the 28 days inhospital mortality rate.
Conflict of Interests
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