Caspian Journal of Internal Medicine

en N-acetylcysteine as adjuvant therapy for hospitalized Covid-19 patients: A single-center prospective cohort study Internal Internal Original Article Original Article Background: Whilst over two years have passed since the COVID-19 pandemic's emergence, the proper management of the disease remains challenging. N-acetylcysteine (NAC) as a potentially effective therapeutic option has been suggested by studies, while the exact clinical role of this agent is yet to be evaluated. Methods: This prospective case-control study was conducted in a major referral respiratory center in Tehran, Iran. We enrolled 217 patients treated with an intravenous daily dose of 1500 mg NAC as a case group; and 245 control patients who did not receive NAC. Two groups were matched based on other treatments, socio-demographics, medical history, and comorbidities. Results: After ten days of adjuvant therapy with NAC, patients in the NAC group and control group had median room-air SpO2 of 91% and 88%, respectively (P=0.02). Also, the SpO2 to FiO2 ratio had a median of 463 and 421 in the case and control groups, respectively (P=0.01). Furthermore, the case group's hospitalization period was three days shorter (P=0.002). Further, cough, dyspnea, and decreased appetite were reported to have a significantly lower incidence in the case group (P=0.03, 0.001, 0.008). Conclusion: We showed that a daily intravenous dose of NAC in hospitalized COVID-19 patients could shorten the hospital stay and improve some clinical symptoms; however, it does not remarkably improve the risk of ICU admission and the 28 days in-hospital mortality rate. N-acetylcysteine, antioxidant, SARS-Cov-2, COVID-19, mortality 543 552 http://caspjim.com/browse.php?a_code=A-10-2672-1&slc_lang=en&sid=1 Siamak Afaghi siamak.afaghi@sbmu.ac.ir 100319475328460043140 100319475328460043140 Yes Research Institute of Internal Medicine, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Negin Moghimi Moghiminegin@gmail.com 100319475328460043141 100319475328460043141 No Research Institute of Internal Medicine, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Nasser Malekpour Alamdari Nassermalekpour@gmail.com 100319475328460043142 100319475328460043142 No Clinical Research and Development Center, Department of Surgery, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Fatemeh Sadat Rahimi T.rahimi@sbmu.ac.ir 100319475328460043143 100319475328460043143 No Clinical Research and Development Center, Department of Surgery, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Rana Irilouzadian Ranairilouzadian@gmail.com 100319475328460043144 100319475328460043144 No Research Institute of Internal Medicine, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Farzad Esmaeili Tarki Farzad.esmaeili.t@sbmu.ac.ir 100319475328460043145 100319475328460043145 No Research Institute of Internal Medicine, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Morvarid Moghimi Morvaridmoghimi@ut.ac.ir 100319475328460043146 100319475328460043146 No School of Chemical Engineering, Faculty of Engineering, University of Tehran, Tehran, Iran Sara Beshaarat Besharat.sara@gmail.com 100319475328460043147 100319475328460043147 No Department of Radiology, Shahid Labafi Nejad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Hossein Salehi Omran Hosseinsalehiomran@gmail.com 100319475328460043148 100319475328460043148 No Clinical Research and Development Center, Department of Surgery, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Anita Karimi Anita.karimi76@gmail.com 100319475328460043149 100319475328460043149 No Research Institute of Internal Medicine, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran