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Home   COVID-19 treatment studies for N-acetylcysteine  COVID-19 treatment studies for N-acetylcys..  C19 studies: N-acetylcys..  N-acetylcys..   Select treatmentSelect treatmentTreatmentsTreatments
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0 0.5 1 1.5 2+ Mortality 2% Improvement Relative Risk Ventilation 27% Improvement 6% Discharge 5% c19early.org/na Mousapour et al. IRCT20210726051995N1 N-acetylcysteine RCT LATE Is late treatment with N-acetylcysteine beneficial for COVID-19? Double-blind RCT 83 patients in Iran Trial underpowered for serious outcomes Mousapour et al., Gastroenterology and Hepatolog.., doi:10.22037/ghfbb.v15i3.2565 Favors N-acetylcysteine Favors control
Efficacy and Safety of Acetylcysteine for the Prevention of Liver Injury in Covid-19 Intensive Care Unit Patients Under Treatment with Remdesivir: A Double-Blind, Placebo-Controlled Randomized Clinical Trial: Prevention of liver injury in severe Covid-19 pneumonia
Mousapour et al., Gastroenterology and Hepatology from Bed to Bench, doi:10.22037/ghfbb.v15i3.2565, IRCT20210726051995N1
Mousapour et al., Efficacy and Safety of Acetylcysteine for the Prevention of Liver Injury in Covid-19 Intensive Care Unit.., Gastroenterology and Hepatology from Bed to Bench, doi:10.22037/ghfbb.v15i3.2565, IRCT20210726051995N1
Jun 2022   Source   PDF  
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RCT 83 severe COVID-19 pnuemonia patients in Iran, 42 treated with acetylcysteine, showing no significant difference in clinical outcomes. All patients received remdesivir, famotidine, and vitamin C. More patients were at baseline category 4+ in the treatment group - 18 vs. 12. The trial focused on preventing liver injury in patients treated with remdesivir, showing improved AST/ALT levels with acetylcysteine.
risk of death, 2.4% lower, RR 0.98, p = 1.00, treatment 4 of 42 (9.5%), control 4 of 41 (9.8%), NNT 430, day 14.
risk of mechanical ventilation, 26.8% lower, RR 0.73, p = 0.57, treatment 6 of 42 (14.3%), control 8 of 41 (19.5%), NNT 19, day 14.
risk of no improvement, 6.1% lower, RR 0.94, p = 0.82, treatment 25 of 42 (59.5%), control 26 of 41 (63.4%), NNT 26, day 14.
risk of no hospital discharge, 5.4% lower, RR 0.95, p = 0.80, treatment 31 of 42 (73.8%), control 32 of 41 (78.0%), NNT 24, day 14.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Mousapour et al., 20 Jun 2022, Double Blind Randomized Controlled Trial, placebo-controlled, Iran, peer-reviewed, mean age 62.1, 5 authors, trial IRCT20210726051995N1.
Contact: dr.hazrati.e@ajaums.ac.ir.
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This PaperN-acetylcys..All
Abstract: Gastroenterology and Hepatology From Bed to Bench. ©2022 RIGLD, Research Institute for Gastroenterology and Liver Diseases ORIGINAL ARTICLE Efficacy and safety of acetylcysteine for the prevention of liver injury in COVID-19 intensive care unit patients under treatment with remdesivir Pouria Mousapour1, Ramin Hamidi Farahani2, Reza Mosaed3, Ali Asgari2, Ebrahim Hazrati1 1 Department of Anesthesiology and Intensive Care, AJA University of Medical Sciences, Tehran, Iran 2 Department of Infectious Diseases, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran 3 Department of Clinical Pharmacy, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran ABSTRACT Aim: The present double-blinded placebo-controlled randomized clinical trial evaluated prophylactic use of acetylcysteine for the prevention of liver injury in patients with severe COVID-19 pneumonia under treatment with remdesivir. Background: Liver injury is reportedly common in patients with severe COVID-19 pneumonia and can occur not only as a result of disease progression, but as an iatrogenic reaction to remdesivir. Methods: A total of 83 adult patients with severe COVID-19 pneumonia were randomly assigned in parallel groups to receive either acetylcysteine or placebo. All the patients received standard care according to institutional protocols, including remdesivir for a total of five days. One gram acetylcysteine was administered intravenously every 12 hours for 42 patients, and 41 patients received the same volume of 0.9% sodium chloride as placebo (Trial Registration: www.irct.ir identifier, IRCT20210726051995N1). Results: After 5 days, median aspartate transaminase (AST) and alanine transaminase (ALT) levels were significantly lower in the acetylcysteine than in the placebo group. Of those who received the placebo, 30 (73.2%), 4 (9.7%), and 3 (7.3%) patients had serum AST levels elevated between 1-2.5, 2.5-5, and over 5 times the upper limit of normal (ULN), respectively; while in the acetylcysteine group, 33 (78.6%) and 0 patients had AST levels between 1-2.5 and over 2.5 times ULN, respectively (p-value=0.037). In the acetylcysteine group, 23 (54.8%), 1 (2.4%), and 1 (2.4%) patient had serum ALT levels elevated between 1-2.5, 2.5-5, and over 5 times ULN, respectively; in the placebo group, however, 24 (58.5%), 7 (17.1%), and 1 (2.4%) patient had serum ALT levels between 1-2.5, 2.5-5, and over 5 times ULN, respectively (p-value=0.073). Conclusion: Intravenous administration of acetylcysteine significantly prevents liver transaminases elevation and liver injury in seriously ill COVID-19 patients treated with remdesivir. Keywords: COVID-19, Coronavirus, Liver injury, Acetylcysteine, Remdesivir, Clinical trial. (Please cite as: Mousapour P, Hamidi Farahani R, Mosaed R, Asgari A, Hazrati E. Efficacy and safety of acetylcysteine for the prevention of liver injury in COVID-19 intensive care unit patients under treatment with remdesivir. Gastroenterol Hepatol Bed Bench 2022;15(3):241-248).
Late treatment
is less effective
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