Impact of N-Acetylcysteine on Modulating Inflammation in Patients Hospitalized with Moderate COVID-19 Infections: A Prospective Randomized Trial
Sara Mohamed Sherkawy, Lamia Elwakeel, Mona F Schaalan, Ayman N Moharram, Mohamed Ahmed Abouelwafa
Archives of Pharmaceutical Sciences Ain Shams University, doi:10.21608/aps.2023.212265.1122
N-acetylcysteine (NAC) is a widely used safe mucolytic, that demonstrated positive impacts on various respiratory diseases via its anti-inflammatory and antioxidant effects. The study aimed to evaluate the potential benefit of adding high-dose oral N-acetylcysteine in hospitalized moderate-severity COVID-19 patients. A prospective, single-center, randomized clinical trial on 60 hospitalized moderate COVID-19 patients who were randomly assigned to the NAC group (30); received NAC daily at 1800 mg added to the institutional protocol, or non-NAC group (30); received only the institutional protocol. Outcomes. The primary outcome was the change in plasma TNF-α, IL-6, and glutathione peroxidase levels. Secondary outcomes were the length of hospital stay, need for oxygen support, duration of oxygenation, and mortality rate between the two study groups. At the study end, a significant decline in TNF-α levels (p< 0.001) and a significant increase in glutathione peroxidase in the NACtreated group (p= 0.001) were evident. Groups were comparable in IL-6 levels (p= 0.810). The duration of oxygen support significantly decreased in the NAC group (p= 0.005). On the contrary, hospital stay length and oxygen support need was not affected by the addition of 0.45, 0.42, respectively). The mortality rate was comparable in both groups. In conclusion, the Addition of 1800 mg of NAC to the institutional treatment protocol for moderate COVID-19 patients has led to a decline in the levels of plasma TNF-α and increased glutathione peroxidase levels. Moreover, the duration required for oxygen support decreased in patients needing supplemental oxygenation.
Declarations
Ethics approval and consent to participate The study protocol was approved by the Scientific Research Ethics Committee, Faculty of Pharmacy, Ain Shams University (No. 128). Written informed consents were signed and collected from all the study participants.
Consent to publish All authors have read and agreed to the published version of the manuscript.
Competing interests The authors have no competing interests.
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