The beneficial role of N-acetylcysteine as an adjunctive drug in treatment of COVID-19 patients in a tertiary care hospital in India: an observational study
Raja Bhattacharya, Maitry Mondal, Subhendu Bikash Naiya, Lamsaka Lyngdoh, Dr Rishav Mukherjee, Prabhat K Singh
International Journal of Research in Medical Sciences, doi:10.18203/2320-6012.ijrms20204010
Background: N-acetyl cysteine, a mucolytic agent, demonstrates free radical scavenging and anti-inflammatory properties, and prevents endothelial dysfunction by inhibition of NF-KB and formation of no adducts. This has a potential role to tackle cytokine storms, endothelial dysfunction and prothrombotic state observed in COVID-19 manifestations like ARDS and Multi organ dysfunction. Methods: Institution based descriptive cross sectional study, 164 patients from laboratory confirmed RT PCR positive COVID-19 patients, in the study period from 27 th May 2020 to 10 th August 2020, were assessed, in medical college Kolkata, a dedicated COVID-19 care facility. Results: It was observed that moderate-severe patients who received N-acetyl cysteine along with standard therapy had average hospital stay duration of 12 days, higher rate of discharge, average duration of oxygen therapy of 8 days, less number of deaths and reduced transfer to critical care facilities. Conclusions: N-acetyl cysteine can be considered as an adjunctive therapy with standard protocol driven care, due to its beneficial anti-inflammatory and free radical scavenging properties.
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'abstract': '<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>While '
'several trials are ongoing for treatment of COVID-19, scientific research on chemoprophylaxis '
'is still lacking even though it has potential to delay the pandemic allowing us time to '
'complete research on '
'vaccines.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We have '
'conducted a cohort study amongst Health Care Workers (HCW) exposed to COVID-19 patients, at a '
'tertiary care center in India where there was an abrupt cluster outbreak within on duty '
'personnel. HCWs who had voluntarily taken hydroxychloroquine (HCQ) prior to exposure were '
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'incidence rates of rtPCR positive COVID-19 infection amongst HCQ users and non '
'users.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>106 healthcare '
'workers were examined in this cohort study of whom 54 were HCQ users and rest were not. The '
'comparative analysis of incidence of infection between the two groups demonstrated that '
'voluntary HCQ usage was associated with lesser likelihood of developing SARS-CoV-2 infection, '
'compared to those who were not on it, X2=14.59, p<0.001. None of the HCQ users noted any '
'serious adverse '
'effects.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>This study '
'demonstrated that voluntary HCQ consumption as pre-exposure prophylaxis by HCWs is associated '
'with a statistically significant reduction in risk of SARS-CoV-2. These promising findings '
'therefore highlight the need to examine this association in greater detail among a larger '
'sample using Randomised Controlled Trials (RCT).</jats:p></jats:sec>',
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