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All Studies   Meta Analysis    Recent:   

Efficacy of N-acetyl Cysteine in Severe COVID-19 Patients: A Randomized Controlled Phase III Clinical Trial

Rahimi et al., Jundishapur Journal of Natural Pharmaceutical Products, doi:10.5812/jjnpp-129817
Oct 2022  
  Source   PDF   All Studies   Meta AnalysisMeta
Mortality 33% Improvement Relative Risk Hospitalization time 8% N-acetylcysteine  Rahimi et al.  ICU PATIENTS  RCT Is very late treatment with N-acetylcysteine beneficial for COVID-19? RCT 40 patients in Iran Lower mortality with N-acetylcysteine (not stat. sig., p=0.19) Rahimi et al., Jundishapur J. Natural .., Oct 2022 FavorsN-acetylcysteine Favorscontrol 0 0.5 1 1.5 2+
14th treatment shown to reduce risk in February 2021
*, now with p = 0.000027 from 24 studies, recognized in 3 countries.
Lower risk for mortality, hospitalization, and cases.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,400+ studies for 79 treatments.
RCT 40 ICU patients in Iran, showing lower mortality with NAC treatment, without statistical significance. Single dose intravenous NAC 300 mg/kg.
Although the 33% lower mortality is not statistically significant, it is consistent with the significant 31% lower mortality [14‑44%] from meta analysis of the 20 mortality results to date.
risk of death, 33.3% lower, RR 0.67, p = 0.19, treatment 10 of 20 (50.0%), control 15 of 20 (75.0%), NNT 4.0.
hospitalization time, 7.5% lower, relative time 0.92, p = 0.63, treatment 20, control 20.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Rahimi et al., 8 Oct 2022, Single Blind Randomized Controlled Trial, Iran, peer-reviewed, 10 authors.
This PaperN-acetylcys..All
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' 'Methods: This single-blinded randomized controlled phase III clinical trial included 40 ' 'patients with confirmed COVID-19 (based on polymerase chain reaction) admitted to the Shahid ' 'Mohammadi Hospital’s ICU, Bandar Abbas, Iran, in 2020. All cases had severe COVID-19. They ' 'were allocated randomly to two equal groups. Patients in the control group received standard ' 'drug therapy based on the treatment protocol of the national COVID-19 committee, while those ' 'in the NAC group received a single dose of intravenous NAC (300 mg/kg) upon admission to the ' 'ICU in addition to standard drug treatment. Clinical status and laboratory tests were done on ' 'admission to the ICU and then 14 days later or at discharge without knowing the patient ' 'grouping. Results: The two groups were comparable regarding age, gender, and other baseline ' 'laboratory and clinical parameters. At the final evaluation, respiratory rate (21.25 ± 4.67 ' 'vs. 27.37 ± 6.99 /min) and D-dimer (186.37 ± 410.23 vs. 1339.04 ± 2183.87 ng/mL) were ' 'significantly lower in the NAC group (P = 0.004 and P = 0.030, respectively). Also, a lower ' 'percentage of patients in the NAC group had lactate dehydrogenase (LDH) ≤ 245 U/L (0% vs. ' '25%, P = 0.047). Although the length of ward and ICU stay was shorter in the NAC group than ' 'in controls, the difference was statistically insignificant (P = 0.598 and P = 0.629, ' 'respectively). Mortality, on the other hand, was 75% in the control group and 50% in the NAC ' 'group, with no statistically significant difference (P = 0.102). Concerning the change in the ' 'study parameters, only the decrease in diastolic blood pressure (DBP) was significantly ' 'higher with NAC (P = 0.042). The intubation and mechanical ventilation rates were higher, ' 'while oxygen with mask and nasal oxygen rates were lower with NAC, but the difference was ' 'statistically insignificant. Conclusions: Based on the current research, NAC is related to a ' 'significant decrease in RR, D-dimer, and DBP in severe COVID-19. Also, LDH was significantly ' 'lower in the NAC group than in the controls. 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Late treatment
is less effective
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