J Med Virol . Evaluation the efficacy and safety of N-acetylcysteine inhalation spray in controlling the symptoms of patients with COVID-19: An open-label randomized controlled clinical trial

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J Med Virol


. 2022 Dec 10.
doi: 10.1002/jmv.28393. Online ahead of print.
Evaluation the efficacy and safety of N-acetylcysteine inhalation spray in controlling the symptoms of patients with COVID-19: An open-label randomized controlled clinical trial


Yunes Panahi ¹ , Mostafa Ghanei ² , Morteza Rahimi ² , Abbas Samim ² , Amir Vahedian-Azimi ³ , Stephen L Atkin ⁴ , Amirhossein Sahebkar ^{5 6 7}



Affiliations

• PMID: 36495185
• DOI: 10.1002/jmv.28393

Abstract

Background: The aim of this study was to evaluate the effect and safety of N-acetylcysteine (NAC) inhalation spray in the treatment of patients with coronavirus disease 2019 (COVID-19).
Methods: This randomized controlled clinical trial study was conducted on patients with COVID-19. Eligible patients (n=250) were randomly allocated into the intervention group (routine treatment + NAC inhaler spray one puff per 12 hours, for 7 days) or the control group who received routine treatment alone. Clinical features, hemodynamic, hematological, biochemical parameters and patient outcomes were assessed and compared before and after treatment.
Results: The mortality rate was significantly higher in the control group than in the intervention group (39.2% vs 3.2%, P<0.001). Significant differences were found between the two groups (intervention and control, respectively) for white blood cell count (6.2 vs 7.8, P<0.001), hemoglobin (12.3 vs 13.3, P=0.002), C-reactive protein (CRP: 6 vs 11.5, P<0.0001) and aspartate aminotransferase (AST: 32 vs 25.5, P<0.0001). No differences were seen for hospital length of stay (11.98±3.61 vs 11.81±3.52, P=0.814) or the requirement for ICU admission (7.2% vs 11.2%, P=0.274).
Conclusions: NAC was beneficial in reducing the mortality rate in patients with COVID-19 and inflammatory parameters, and a reduction in the development of severe respiratory failure; however, it did not affect the length of hospital stay or the need for ICU admission. Data on the effectiveness of NAC for SARS-CoV-2 is limited and further research is required.
Clinical trial registration: This study Registered at Iranian Registry of Clinical Trials (IRCT20080901001165N55) dated 23-05-2020. This article is protected by copyright. All rights reserved.

Keywords: N-acetylcysteine; clinical trial; severe acute respiratory syndrome coronavirus 2.