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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 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.
Restrict:    All    Early    Late    Prophylaxis
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
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
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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Thanks for your feedback! Please search before submitting papers and note that studies are listed under the date they were first available, which may be the date of an earlier preprint.