Use of N-Acetylcysteine at high doses as an oral treatment for patients hospitalized with COVID-19
José Luis Izquierdo, Joan B Soriano, Yolanda González, Sara Lumbreras, Julio Ancochea, Christian Echeverry, José Miguel Rodríguez
Science Progress, doi:10.1177/00368504221074574
Infection by SARS-CoV-2 causing coronavirus disease 2019 (COVID-19) can be associated with serious and life-threatening conditions, including acute respiratory distress syndrome (ARDS). Severity and mortality have been related to a cytokine storm, an imbalance of oxidative stress, and a pro-thrombotic state. We conducted an observational retrospective cohort study from a community-based large population of hospitalized COVID-19 PCR + patients admitted from March 01, 2020, to January 24, 2021, with integrated primary to tertiary care information in Castilla la Mancha, Spain. We
ORCID iDs José
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'abstract': '<jats:p> Infection by SARS-CoV-2 causing coronavirus disease 2019 (COVID-19) can be '
'associated with serious and life-threatening conditions, including acute respiratory distress '
'syndrome (ARDS). Severity and mortality have been related to a cytokine storm, an imbalance '
'of oxidative stress, and a pro-thrombotic state. </jats:p><jats:p> We conducted an '
'observational retrospective cohort study from a community-based large population of '
'hospitalized COVID-19 PCR\u2009+\u2009patients admitted from March 01, 2020, to January 24, '
'2021, with integrated primary to tertiary care information in Castilla la Mancha, Spain. We '
'explored the potential benefits of the antioxidant, anti-inflammatory and anti-thrombotic '
'drug N-acetylcysteine (NAC) administered orally in high doses (600\u2005mg every 8\u2005h), '
'added to standard of care in COVID-19 patients by using the free text information contained '
'in their electronic health records (EHRs). </jats:p><jats:p> Out of 19,208 patients with a '
'diagnosis of COVID-19 hospitalized, we studied 2071 (10.8%) users of oral NAC at high doses. '
'COVID-19 patients treated with NAC were older, predominantly male, and with more '
'comorbidities such as hypertension, dyslipidemia, diabetes, and COPD when compared with those '
'not on NAC (all p\u2009<\u20090.05). Despite greater baseline risk, use of NAC in COVID-19 '
'patients was associated with significantly lower mortality (OR 0.56; 95%CI 0.47–0.67), a '
'finding that remained significant in a multivariate analysis adjusting by baseline '
'characteristics and concomitant use of corticosteroids. There were no significant differences '
'with the use of NAC on the mean duration of hospitalization, admission to the intensive care '
'unit or use of invasive mechanical ventilation. The observed association signaling to better '
'relevant outcomes in COVID-19 patients treated with NAC at high doses should be further '
'explored in other settings and populations and in randomized controlled trials. </jats:p>',
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