N-acetyl-cysteine reduces the risk for mechanical ventilation and mortality in patients with COVID-19 pneumonia: a two-center retrospective cohort study
Stelios F. Assimakopoulos, Διαμάντω Αρέθα, Dimitrios Komninos, Dimitra Dimitropoulou, Maria Lagadinou, Λεωνιδία Λεωνίδου, Ioanna Oikonomou, Αthanasia Mouzaki, Markos Marangos
Abstract
BACKGROUND: N-acetyl-cysteine (NAC) has been previously shown to exert beneficial effects in diverse respiratory diseases, through antioxidant and anti-inflammatory actions. Our aim was to evaluate NAC potential impact in hospitalised patients with COVID-19 pneumonia, in terms of progression to severe respiratory failure (SRF) and mortality. PATIENTS AND METHODS: <150) requiring mechanical ventilation support and (ii) mortality at 14 and 28 days. RESULTS: < .001, respectively). NAC improved over time the PO2/FiO2 ratio and decreased the white blood cell, CRP, D-dimers and LDH levels. In the multivariable logistic regression analysis, non-severe illness and NAC administration were independent predictors of 28-days survival. CONCLUSION: Oral NAC administration (1200 mg/d) in patients with COVID-19 pneumonia reduces the risk for mechanical ventilation and mortality. Our findings need to be confirmed by properly designed prospective clinical trials.