N-acetylcysteine in the complex treatment of COVID-19 pneumonia

N-acetylcysteine in the complex treatment of COVID-19 pneumonia

S.N. Avdeev^1,2, V.V. Gainitdinova¹, Z.M. Merzhoeva¹, Z.G.-M. Berikhanov¹, I.V. Medvedeva¹, T.L. Gorbacheva¹

¹Sechenov University, Moscow

²Research Institute of Pulmonology of the Russian Federal Medical Biological Agency, Moscow

Background: the available data on the treatment results of a new coronavirus infection (COVID-19) using all medicinal products do not allow for making a firm conclusion about their efficacy or inefficacy. Therefore, their use is permissible by decision of the medical commission in accordance in the prescribed manner, if the potential benefit to the patient exceeds the risk of their use. Drug choice for COVID-19 treatment regimens is based on data on efficacy and safety, their mechanism of action, and potential interactions. Pharmacological activity of N-acetylcysteine (NAC) and its potential effect in inhibition the progression of COVID-19 make it a promising therapeutic agent in COVID-19.

Aim: to evaluate the efficacy of NAC in the comprehensive treatment of a moderate COVID-19 pneumonia.

Patients and Methods: the study included adult patients (n=46) with moderate COVID-19 pneumonia, grade 2 CT. The age of the patients was 57 (51; 71) years, BMI — 30 (27.1; 32.3) kg/m², disease duration before hospitalization — 7 (6; 8) days, temperature at the time of hospitalization — 37.5 (37.1; 37.8) °C. Two study groups were randomly formed. The first group (n=22) received standard COVID-19 treatment. Patients of the second group (n=24) additionally received NAC 1200–1500 mg/day intravenously. NAC was prescribed simultaneously during the initiation of standard therapy.

Results: this study showed that the inclusion of NAC in the comprehensive treatment of moderate COVID-19 pneumonia led to a statistically significant increase in the oxygen saturation, oxygenation index, difference in delta increase of the oxygenation index, higher rate of decline in the volume of lung damage and inter-group difference in delta decline. There was also a statistically significantly more intense rate of a decrease in C-reactive protein levels than in the standard treatment group and a reduction of hospitalization duration in the group receiving NAC.

Conclusion: study results indicated the efficacy of NAC inclusion in the comprehensive treatment of moderate COVID-19 pneumonia.

Keywords: COVID-19 pneumonia, oxygenation index, lung damage volume, hospitalization duration, treatment, N-acetylcysteine.

For citation: Avdeev S.N., Gainitdinova V.V., Merzhoeva Z.M. et al. N-acetylcysteine in the complex treatment of COVID-19 pneumonia. RMJ. 2021;3:13–18.