Impact of N-Acetylcysteine on Modulating Inflammation in Patients Hospitalized with Moderate COVID-19 Infections: A Prospective Randomized Trial | ||||
| Archives of Pharmaceutical Sciences Ain Shams University | ||||
| Volume 7, Issue 1, June 2023, Page 129-146 PDF (918.72 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/aps.2023.212265.1122 | ||||
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| Authors | ||||
Sara M Sherkawy1; Lamia Elwakeel   2; Mona Schaalan3; Ayman Moharram4; Mohamed Abouelwafa4
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| 1Clinical Pharmacy Department, Faculty of Pharmacy, Misr International University, Cairo, Egypt | ||||
| 2Department of Clinical Pharmacy, Faculty of Pharmacy, Ain Shams University, Cairo 11566, Egypt | ||||
| 3Department of Clinical Pharmacy, Faculty of Pharmacy, Misr International University, Cairo, Egypt | ||||
| 4Department of Critical Care Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt | ||||
| Abstract | ||||
| Background. 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 potential benefit of adding high dose oral N- acetylcysteine in hospitalized moderate-severity COVID-19 patients. Methodology. A prospective, single- center, randomized clinical trial on 60 hospitalized moderate COVID-19 patients who were randomly assigned to NAC group (30); received NAC daily at 1800 mg added to institutional protocol, or non-NAC group (30); received only the institutional protocol. Outcomes. Primary outcome was the change in plasma TNF-α, IL-6 and glutathione peroxidase level. Secondary outcomes were the length of hospital stay, need for oxygen support, duration on oxygenation and mortality rate between the two study groups. Results. At study-end, a significant decline in TNF-α levels (p< 0.001) and a significant increase in glutathione peroxidase in the NAC treated group (p=0.001) was evident. Groups were comparable in IL-6 levels (p=0.810). The duration on oxygen support significantly decreased in NAC group (p=0.005). On the contrary, hospital stay length and oxygen support need was not affected by addition of NAC (p- values, 0.45, 0.42, respectively). Mortality rate was comparable in both groups. Conclusion. Addition of 1800 mg of NAC to institutional treatment protocol for moderate COVID-19 patients have led to a decline in the levels of plasma TNF-α and increased glutathione peroxidase levels. Moreover, duration required on oxygen support decreased in patients needing supplemental oxygenation. | ||||
| Keywords | ||||
| NAC; TNF-α; IL-6; glutathione peroxidase; oxygen support; Covid-19 | ||||
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