PMID- 35084258
OWN - NLM
STAT- MEDLINE
DCOM- 20220202
LR  - 20220202
IS  - 2047-7163 (Electronic)
IS  - 0036-8504 (Print)
IS  - 0036-8504 (Linking)
VI  - 105
IP  - 1
DP  - 2022 Jan-Mar
TI  - Use of N-Acetylcysteine at high doses as an oral treatment for patients 
      hospitalized with COVID-19.
PG  - 368504221074574
LID - 10.1177/00368504221074574 [doi]
LID - 00368504221074574
AB  - Infection by SARS-CoV-2 causing coronavirus disease 2019 (COVID-19) can be 
      associated with serious and life-threatening conditions, including acute 
      respiratory distress syndrome (ARDS). Severity and mortality have been related to 
      a cytokine storm, an imbalance of oxidative stress, and a pro-thrombotic state.We 
      conducted an observational retrospective cohort study from a community-based 
      large population of hospitalized COVID-19 PCR + patients admitted from March 01, 
      2020, to January 24, 2021, with integrated primary to tertiary care information 
      in Castilla la Mancha, Spain. We explored the potential benefits of the 
      antioxidant, anti-inflammatory and anti-thrombotic drug N-acetylcysteine (NAC) 
      administered orally in high doses (600 mg every 8 h), added to standard of care 
      in COVID-19 patients by using the free text information contained in their 
      electronic health records (EHRs).Out of 19,208 patients with a diagnosis of 
      COVID-19 hospitalized, we studied 2071 (10.8%) users of oral NAC at high doses. 
      COVID-19 patients treated with NAC were older, predominantly male, and with more 
      comorbidities such as hypertension, dyslipidemia, diabetes, and COPD when 
      compared with those not on NAC (all p < 0.05). Despite greater baseline risk, use 
      of NAC in COVID-19 patients was associated with significantly lower mortality (OR 
      0.56; 95%CI 0.47-0.67), a finding that remained significant in a multivariate 
      analysis adjusting by baseline characteristics and concomitant use of 
      corticosteroids. There were no significant differences with the use of NAC on the 
      mean duration of hospitalization, admission to the intensive care unit or use of 
      invasive mechanical ventilation. The observed association signaling to better 
      relevant outcomes in COVID-19 patients treated with NAC at high doses should be 
      further explored in other settings and populations and in randomized controlled 
      trials.
FAU - Izquierdo, Jose Luis
AU  - Izquierdo JL
AUID- ORCID: 0000-0002-1671-2243
AD  - Department of Medicine and Medical Specialties, Universidad de Alcala, Madrid, 
      Spain.
AD  - Respiratory Medicine, Hospital Universitario de Guadalajara, Guadalajara, Spain.
FAU - Soriano, Joan B
AU  - Soriano JB
AD  - Respiratory Medicine, 16517Hospital Universitario de La Princesa, Madrid, Spain.
AD  - Universidad Autonoma de Madrid, Madrid, Spain.
AD  - Respiratory Diseases Networking Biomedical Research Centre (CIBERES), Institute 
      of Health Carlos III (ISCIII), Madrid, Spain.
FAU - Gonzalez, Yolanda
AU  - Gonzalez Y
AD  - SAVANA.
FAU - Lumbreras, Sara
AU  - Lumbreras S
AD  - SAVANA.
AD  - 16768Universidad Pontificia Comillas-IIT, Madrid, Spain.
FAU - Ancochea, Julio
AU  - Ancochea J
AUID- ORCID: 0000-0001-7451-4133
AD  - Respiratory Medicine, 16517Hospital Universitario de La Princesa, Madrid, Spain.
AD  - Universidad Autonoma de Madrid, Madrid, Spain.
AD  - Respiratory Diseases Networking Biomedical Research Centre (CIBERES), Institute 
      of Health Carlos III (ISCIII), Madrid, Spain.
FAU - Echeverry, Christian
AU  - Echeverry C
AD  - SAVANA.
FAU - Rodriguez, Jose Miguel
AU  - Rodriguez JM
AD  - Department of Medicine and Medical Specialties, Universidad de Alcala, Madrid, 
      Spain.
AD  - Respiratory Medicine, 16269Hospital Universitario Principe de Asturias, Alcala de 
      Henares, Madrid, Spain.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - England
TA  - Sci Prog
JT  - Science progress
JID - 0411361
RN  - WYQ7N0BPYC (Acetylcysteine)
SB  - IM
MH  - Acetylcysteine/therapeutic use
MH  - *COVID-19
MH  - Hospitalization
MH  - Humans
MH  - Male
MH  - Retrospective Studies
MH  - SARS-CoV-2
MH  - Treatment Outcome
PMC - PMC8795755
OTO - NOTNLM
OT  - COVID-19
OT  - N-acetylcysteine
OT  - mortality
OT  - treatment
OT  - use of health services
COIS- The author(s) declared no potential conflicts of interest with respect to the 
      research, authorship, and/or publication of this article.
EDAT- 2022/01/28 06:00
MHDA- 2022/02/03 06:00
PMCR- 2022/01/27
CRDT- 2022/01/27 12:14
PHST- 2022/01/27 12:14 [entrez]
PHST- 2022/01/28 06:00 [pubmed]
PHST- 2022/02/03 06:00 [medline]
PHST- 2022/01/27 00:00 [pmc-release]
AID - 10.1177_00368504221074574 [pii]
AID - 10.1177/00368504221074574 [doi]
PST - ppublish
SO  - Sci Prog. 2022 Jan-Mar;105(1):368504221074574. doi: 10.1177/00368504221074574.