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0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Altay (DB RCT) 80% 0.20 [0.01-4.85] hosp. 0/229 1/76 CT​1 Improvement, RR [CI] Treatment Control Ignatova 20% 0.80 [0.64-1.00] hosp. time 56 (n) 55 (n) Tau​2 = 0.00, I​2 = 0.0%, p = 0.043 Early treatment 21% 0.79 [0.63-0.99] 0/285 1/131 21% improvement de Alencar (DB RCT) -3% 1.03 [0.41-2.27] death 9/67 9/68 Improvement, RR [CI] Treatment Control Gaynitdinova (RCT) 15% 0.85 [0.77-0.93] hosp. time 24 (n) 22 (n) Taher (DB RCT) 18% 0.82 [0.43-1.58] death 12/47 14/45 Assimakopoulos 97% 0.03 [0.00-0.30] death 2/42 12/40 Avdeev 69% 0.31 [0.03-2.72] death 1/24 3/22 Tau​2 = 0.55, I​2 = 81.8%, p = 0.071 Late treatment 52% 0.48 [0.22-1.06] 24/204 38/197 52% improvement Huh 26% 0.74 [0.68-0.80] cases population-based cohort Improvement, RR [CI] Treatment Control Tau​2 = 0.00, I​2 = 0.0%, p < 0.0001 Prophylaxis 26% 0.74 [0.68-0.80] 26% improvement All studies 25% 0.75 [0.61-0.91] 24/489 39/328 25% improvement 8 N-acetylcysteine COVID-19 studies c19early.com/na Jan 16, 2022 Tau​2 = 0.03, I​2 = 73.5%, p = 0.0041 Effect extraction pre-specified 1 CT: study uses combined treatment Favors N-acetylcysteine Favors control
N-acetylcysteine COVID-19 studies. Recently added: Taher Ignatova de Alencar Gaynitdinova Assimakopoulos Avdeev Huh. Submit updates/corrections.
 
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Nov 10
Early Ignatova et al., Russian Medical Inquiry, doi:10.32364/2587-6821-2021-5-7-473-478 (Peer Reviewed)
hosp. time, ↓20.3%, p<0.05
Therapeutic possibilities of using an expectorant mucolytic agent with antioxidant properties in COVID-19 infection
Details   Retrospective 111 patients with moderate COVID-19 pneumonia, 56 treated with NAC, showing shorter hospitalization time with treatment. NAC 1200mg daily intravenous, divided into two doses.
Jul 9
Late Avdeev et al., Journal of Infection, doi:10.1016/j.jinf.2021.07.003 (Peer Reviewed)
death, ↓69.4%, p=0.34
N-acetylcysteine for the treatment of COVID-19 among hospitalized patients
Details   Prospective study of 24 hospitalized COVID-19 patients in Russia treated with NAC, and 22 matched controls, showing significantly improved SpO2/FiO2, and significantly shorter hospitalization with treatment.
Jun 29
Late Assimakopoulos et al., Infectious Diseases, doi:10.1080/23744235.2021.1945675 (Peer Reviewed)
death, ↓97.1%, p=0.006
N-acetyl-cysteine reduces the risk for mechanical ventilation and mortality in patients with COVID-19 pneumonia: a two-center retrospective cohort study
Details   Retrospective 42 hospitalized PCR+ COVID-19 pneumonia patients treated with NAC, and a matched control group of 40 patients, showing significantly lower severe respiratory failure and significantly lower mortality with treatment. NAC 600 ..
Jun 28
Early Altay et al., Advanced Science, doi:10.1002/advs.202101222 (Peer Reviewed)
hosp., ↓80.1%, p=0.25
Combined Metabolic Activators Accelerates Recovery in Mild-to-Moderate COVID-19
Details   RCT 304 low-risk outpatients, 229 treated with N-acetylcysteine, l-carnitine tartrate, nicotinamide riboside chloride, and serine, showing significantly faster recovery with treatment. Plasma levels of proteins and metabolites associated ..
Jun 10
Late Taher et al., Pharmacological Reports, doi:10.1007/s43440-021-00296-2 (Peer Reviewed)
death, ↓17.9%, p=0.65
A pilot study on intravenous N-Acetylcysteine treatment in patients with mild-to-moderate COVID19-associated acute respiratory distress syndrome
Details   RCT 92 hospitalized patients, 47 treated with NAC, showing non-significant improvements in outcomes. IRCT20120215009014N355. NAC 40mg/kg/day intravenous for 3 days.
Feb 19
Late Gaynitdinova et al., Pulmonologiya, doi:10.18093/0869-0189-2021-31-1-21-29 (Peer Reviewed)
hosp. time, ↓15.4%, p<0.001
N-acetylcysteine as a part of complex treatment of moderate COVID-associated pneumonia
Details   RCT 46 hospitalized patients with moderate COVID-19 pneumonia, 24 treated wth N-acetylcysteine, showing significantly shorter hospitalization with treatment. NAC 1,200 – 1,500mg/day intravenously.
Sep 23
2020
Late de Alencar et al., Clinical Infectious Diseases, doi:10.1093/cid/ciaa1443 (Peer Reviewed)
death, ↑2.6%, p=0.94
Double-blind, Randomized, Placebo-controlled Trial With N-acetylcysteine for Treatment of Severe Acute Respiratory Syndrome Caused by Coronavirus Disease 2019 (COVID-19)
Details   RCT 135 severe stage patients in Brazil, showing no significant differences. NAC 21g (~300mg/kg) for 20 hours. U1111-1250-356 [1].
May 4
2020
PrEPPEP Huh et al., medRxiv, doi:10.1101/2020.05.04.20089904 (Preprint)
cases, ↓26.2%, p<0.0001
Association of previous medications with the risk of COVID-19: a nationwide claims-based study from South Korea
Details   Retrospective database analysis of 65,149 in South Korea, showing significantly lower cases with existing N-acetylcysteine treatment.
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