Therapeutic possibilities of using an expectorant mucolytic agent with antioxidant properties in COVID-19 infection

DOI record: { "DOI": "10.32364/2587-6821-2021-5-7-473-478", "ISSN": [ "2587-6821", "2686-9918" ], "URL": "http://dx.doi.org/10.32364/2587-6821-2021-5-7-473-478", "abstract": "<jats:p>Aim: to study the effect of N-acetylcysteine (NAC) on the dynamics of clinical and radiological changes in patients with COVID-19. Patients and Methods: the study included 111 patients with moderate and severe forms of COVID-19 pneumonia of the 2nd and 3rd stage according to computed tomography (CT). The median age was 49,25 years. Group 1 (n=55) received standard therapy: favipiravir, enoxaparin sodium according to the regimen, dexamethasone. Antibacterial therapy was conducted according to the indications. In addition to standard therapy, group 2 (n=56) was prescribed with NAC at a daily dose of 1200 mg, intravenously, divided into two doses. All patients underwent a comprehensive examination: WBC count, C-reactive protein (CRP), ferritin, fibrinogen, multispiral computed tomography and ultrasound of the chest organs were determined at admission, on the 7th-10th day of hospitalization, at discharge and 8 weeks after discharge. Results: initially, patients from both groups were comparable in terms of demographic indicators and condition severity. NAC prescription to the standard therapy showed a more positive trend both in terms of clinical symptoms and laboratory indicators. Respiratory rate, heart rate, and body temperature were statistically significantly lower in group 2 already on the 7th-10th day of follow-up. The levels of CRP, ferritin and fibrinogen also normalized faster in group 2. The periods of stay in the hospital were 15.3 days and 12.2 days, respectively, in patients from groups 1 and 2 (p&lt;0,05). Conclusions: early prescription with N-acetylcysteine to patients with a moderate course of COVID-19 allowed statistically significantly reducing the volume of lung tissue damage, reducing the level of inflammatory markers (CRP, ferritin, fibrinogen) and contributed to an earlier discharge of the patient. KEYWORDS: COVID-19, N-acetylcysteine, pneumonia, acute respiratory distress syndrome, cytokine storm. FOR CITATION: Ignatova G.L., Antonov V.N., Sheklanova E.V. et al. Therapeutic possibilities of using an expectorant mucolytic agent with antioxidant properties in COVID-19 infection. Russian Medical Inquiry. 2021;5(7):473–478 (in Russ.). DOI: 10.32364/2587-6821-2021- 5-7-473-478.</jats:p>", "author": [ { "affiliation": [], "family": "Ignatova", "given": "G.L.", "sequence": "first" }, { "affiliation": [], "name": "South Ural State Medical University, Chelyabinsk, Russian Federation", "sequence": "first" }, { "affiliation": [], "family": "Antonov", "given": "V.N.", "sequence": "additional" }, { "affiliation": [], "family": "Sheklanova", "given": "E.V.", "sequence": "additional" }, { "affiliation": [], "family": "Korotkaya", "given": "M.A.", "sequence": "additional" }, { "affiliation": [], "family": "Domracheva", "given": "M.V.", "sequence": "additional" }, { "affiliation": [], "family": "Zotov", "given": "S.O.", "sequence": "additional" }, { "affiliation": [], "name": "South Ural State Medical University, Chelyabinsk, Russian Federation", "sequence": "additional" }, { "affiliation": [], "name": "Regional Clinical Hospital No. 3, Chelyabinsk, Russian Federation", "sequence": "additional" }, { "affiliation": [], "name": "Regional Clinical Hospital No. 3, Chelyabinsk, Russian Federation", "sequence": "additional" }, { "affiliation": [], "name": "Regional Clinical Hospital No. 3, Chelyabinsk, Russian Federation", "sequence": "additional" }, { "affiliation": [], "name": "Regional Clinical Hospital No. 3, Chelyabinsk, Russian Federation", "sequence": "additional" } ], "container-title": [ "Russian Medical Inquiry" ], "content-domain": { "crossmark-restriction": false, "domain": [] }, "created": { "date-parts": [ [ 2021, 10, 19 ] ], "date-time": "2021-10-19T14:40:38Z", "timestamp": 1634654438000 }, "deposited": { "date-parts": [ [ 2021, 10, 19 ] ], "date-time": "2021-10-19T14:41:46Z", "timestamp": 1634654506000 }, "indexed": { "date-parts": [ [ 2021, 12, 22 ] ], "date-time": "2021-12-22T15:58:25Z", "timestamp": 1640188705176 }, "is-referenced-by-count": 0, "issn-type": [ { "type": "print", "value": "2587-6821" }, { "type": "electronic", "value": "2686-9918" } ], "issue": "7", "issued": { "date-parts": [ [ 2021 ] ] }, "journal-issue": { "issue": "7", "published-online": { "date-parts": [ [ 2021 ] ] }, "published-print": { "date-parts": [ [ 2021 ] ] } }, "member": "17426", "original-title": [ "Терапевтические возможности применения отхаркивающего муколитического средства с антиоксидантными свойствами при инфекции COVID-19" ], "page": "473-478", "prefix": "10.32364", "published": { "date-parts": [ [ 2021 ] ] }, "published-online": { "date-parts": [ [ 2021 ] ] }, "published-print": { "date-parts": [ [ 2021 ] ] }, "publisher": "LLC Russian Medical Journal", "reference-count": 0, "references-count": 0, "relation": {}, "score": 1, "short-container-title": [ "Russian Medical Inquiry" ], "short-title": [], "source": "Crossref", "subtitle": [], "title": [ "Therapeutic possibilities of using an expectorant mucolytic agent with antioxidant properties in COVID-19 infection" ], "type": "journal-article", "volume": "5" }