Evaluation of the recovery rate and prevention of hospitalization among covid-19 outpatients: a randomized clinical trial comparing N-acetylcysteine with Bromhexine
Anahita Eslami Ghayour, Sasan Nazari, Fariba Keramat, Fatemeh Shahbazi
doi:10.21203/rs.3.rs-2309373/v2
Objectives: Due to the referral of COVID-19 patients to outpatient centers in the early stages, the aim of the present study is to compare the effect of N-acetylcysteine and Bromhexine on the recovery rate and prevention of hospitalization in outpatients with Methodology: This study was conducted from April 2022 to September 2022. First, PCR-con rmed COVID-19 patients were divided into tree groups, one of these groups received N-acetylcysteine while the other received bromhexine and One of these groups did not receive any medication. The patients were followed up on the seventh and fourteenth days of the disease in terms of the duration of changes in oxygen saturation and recovery. The hospitalization and death of the patients were also evaluated after one month. Results: Out of 225 studied patients, oxygen saturation was increased by 1.33% in the third visit of the patients who received N-acetylcysteine compared to their rst visit. This percentage was 1.19% in the patients who received bromhexine.29.77% of the patients were admitted to the hospital and 70.23% of them had no history of hospitalization within 14 day and their mortality rate was 9.33% in control group and it was zero in both groups of patients who received drug. Conclusions: The results of this study showed that early initiation of Bromhexine and N-acetylcysteine can effectively reduce the hospitalization rate and mortality and shorten the duration of hospitalization.
However, more studies are still needed to prove their bene ts Declarations 6.1. Ethics approval and consent to participate: This study was approved by the Research Ethics Committees of Hamadan University of Medical Scienece with the ethics code: IR.UMSHA.REC.1400.957 and this study was approved by the judges of the International Center for Registration of Clinical Trials of Iran, a member of the international centers approved by the World Health Organization and with the code: IRCT20220302054167N1 Con rmed. Informed consent was obtained from all participating patients/their legal guardians in this study after fully explaining the study method, side effects of drugs and other necessary matters. All patients were rst examined in terms of drug allergy history, and then the study was fully explained to the patients, and the questions and doubts of the patients were fully answered, and it was also explained to the patients that for any reason, they wanted to continue participating in the study. do not have, they can withdraw, and this study will not interfere with their treatment. Also, all patients are assured that all their information is con dential and only collective information of the entire study is available. All methods were carried out in accordance with relevant guidelines and regulations.
Consent for publication Not applicable.
Availability data and materials All data generated or analyzed during this study are included in this published article.
Competing..
References
Ansarin, Tolouian, Ardalan, Effect of bromhexine on clinical outcomes and mortality in COVID-19 patients: A randomized clinical trial, Bioimpacts,
doi:10.34172/bi.2020.27Hesni, Sayad, Khosravi Shadmani, Demographics, clinical characteristics, and outcomes of 27,256 hospitalized COVID-19 patients in Kermanshah Province, Iran: a retrospective one-year cohort study, BMC Infect Dis,
doi:10.1186/s12879-022-07312-7Huang, Su, Theron, An interferon-gamma-related cytokine storm in SARS patients, J Med Virol,
doi:10.1002/jmv.20255Izquierdo, Soriano, González, Use of N-Acetylcysteine at high doses as an oral treatment for patients hospitalized with COVID-19, Sci Prog,
doi:10.1177/00368504221074574Lee, Hong, Jang, N-acetylcysteine decreases airway in ammation and responsiveness in asthma by modulating claudin 18 expression, Korean J Intern Med,
doi:10.3904/kjim.2019.105Marchetti, Lodola, Licciardello, Colombo, Use of N-acetylcysteine in the management of coronary artery diseases, Cardiologia
Mccarty, Dinicolantonio, Nutraceuticals have potential for boosting the type 1 interferon response to RNA viruses including in uenza and coronavirus, Prog Cardiovasc Dis,
doi:10.1016/j.pcad.2020.02.007Poppe, Wittig, Jurida, The NF-κB-dependent and -independent transcriptome and chromatin landscapes of human coronavirus 229E-infected cells, PLoS Pathog,
doi:10.1371/journal.ppat.1006286Rumack, Bateman, Acetaminophen and acetylcysteine dose and duration: past, present and future [published correction appears, Clin Toxicol
Stegelmeier, Van Vloten, Mould, Myeloid Cells during Viral Infections and In ammation, Viruses,
doi:10.3390/v11020168Sun, Zhang, Li, Xu, A systematic review of chest imaging ndings in COVID-19, Quant Imaging Med Surg,
doi:10.21037/qims-20-564Suter, Domenighetti, Schaller, Laverrière, Ritz et al., N-acetylcysteine enhances recovery from acute lung injury in man. A randomized, double-blind, placebo-controlled clinical study, Chest,
doi:10.1378/chest.105.1.190Taher, Lashgari, Sedighi, Rahimi-Bashar, Poorolajal et al., A pilot study on intravenous N-Acetylcysteine treatment in patients with mild-to-moderate COVID19-associated acute respiratory distress syndrome, Pharmacol Rep,
doi:10.1007/s43440-021-00296-2Šalamon, Kramar, Marolt, Poljšak, Milisav, Medical and Dietary Uses of N-Acetylcysteine, Antioxidants,
doi:10.3390/antiox8050111
