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Evaluation of the Efficacy and Safety of Oral N-acetylcysteine in Patients With COVID-19 Receiving the Routine Antiviral and Hydroxychloroquine Protocol: A Randomized Controlled Clinical Trial
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  • Najmolsadat Atefi,
  • Azadeh Goodarzi,
  • taghi riahi,
  • niloofar khodabandehloo,
  • mahshid talebitaher,
  • niloofar najar nobari,
  • farnoosh seirafianpour,
  • zeinab mahdi,
  • amir baghestani,
  • rohollah valizadeh
Najmolsadat Atefi
Iran University of Medical Sciences
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Azadeh Goodarzi
Iran University of Medical Sciences

Corresponding Author:[email protected]

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taghi riahi
Iran University of Medical Sciences
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niloofar khodabandehloo
Iran University of Medical Sciences
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mahshid talebitaher
Iran University of Medical Sciences
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niloofar najar nobari
Iran University of Medical Sciences
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farnoosh seirafianpour
Iran University of Medical Sciences
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zeinab mahdi
Iran University of Medical Sciences
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amir baghestani
Iran University of Medical Sciences
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rohollah valizadeh
Iran University of Medical Sciences
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Abstract

ABSTRACT The current absence of gold-standard or all-aspect favorable therapies for COVID-19 renders a focus on multipotential drugs proposed to prevent or treat this infection or ameliorate its signs and symptoms vitally important. The present well-designed randomized controlled trial sought to evaluate the efficacy and safety of N-acetylcysteine as adjuvant therapy in hospitalized Iranian patients with COVID-19. Four different diets in 60 patients include; Kaletra (lopinavir/ritonavir) + hydroxychloroquine with/without N-acetylcysteine (600 mg TDS) and atazanavir/ritonavir + hydroxychloroquine with/without N-acetylcysteine (600 mg TDS), were administered in the study. At the end of the study, a further decrease in C-reactive protein was observed in groups with N-acetylcysteine (P =0.008), and no death occurred in the atazanavir/ritonavir + hydroxychloroquine + N-acetylcysteine group, showing that the combination of these drugs may reduce mortality. A significant rise in O2 saturation was observed in atazanavir/ritonavir+hydroxychloroquine+N-acetylcysteine group (P <0.05). Accordingly, oral or intravenous N-acetylcysteine, may enhance O2 saturation, blunt the inflammation trend (by reducing C-reactive protein), and reduce mortality in hospitalized patients with COVID-19. The N-acetylcysteine could be more effective as prophylactic or adjuvant therapy in stable and non-severe cases of COVID-19 with a particularly positive role in the augmentation of O2 saturation and faster reduction of the CRP level and inflammation.
12 Jun 2023Submitted to Immunity, Inflammation and Disease
13 Jun 2023Submission Checks Completed
13 Jun 2023Assigned to Editor
15 Jun 2023Review(s) Completed, Editorial Evaluation Pending
20 Jun 2023Reviewer(s) Assigned
08 Jul 2023Editorial Decision: Revise Major
27 Aug 20231st Revision Received
29 Aug 2023Submission Checks Completed
29 Aug 2023Assigned to Editor
29 Aug 2023Review(s) Completed, Editorial Evaluation Pending
29 Aug 2023Reviewer(s) Assigned
06 Sep 2023Editorial Decision: Revise Minor
10 Oct 20232nd Revision Received
19 Oct 2023Submission Checks Completed
19 Oct 2023Assigned to Editor
19 Oct 2023Review(s) Completed, Editorial Evaluation Pending
19 Oct 2023Reviewer(s) Assigned
23 Oct 2023Editorial Decision: Revise Minor
24 Oct 20233rd Revision Received
26 Oct 2023Submission Checks Completed
26 Oct 2023Assigned to Editor
26 Oct 2023Review(s) Completed, Editorial Evaluation Pending
31 Oct 2023Editorial Decision: Accept
Nov 2023Published in Immunity, Inflammation and Disease volume 11 issue 11. https://doi.org/10.1002/iid3.1083