CONCLUSIONS
Given the current absence of any gold-standard therapy for the treatment of COVID-19 or its associated complications, multipotential drugs with anti-inflammatory, antioxidant and anti-apoptotic properties could have promising results if indicated or used in a proper setting. We designed one of the best-designed RCTs to date to evaluate the efficacy and safety of NAC in the treatment of patients with COVID-19. The salient findings of this RCT were that at the end of the study, a further drop in C-reactive protein was detected in the NAC group (P =0.008), and no death occurred in the atazanavir/ritonavir + HCQ + NAC group, indicating that the combination of these drugs may lessen mortality. Moreover, the atazanavir/ritonavir + HCQ and atazanavir/ritonavir + HCQ + NAC groups had the highest O2 saturation at the end of the study and a significant elevation in O2 saturation after the start of the intervention, including NAC (P<0.05). In light of the findings of the present RCT, we can conclude that oral or intravenous NAC, if indicated, may boost O2 saturation, blunt the inflammation trend (by reducing C-reactive protein), and decline mortality in hospitalized patients with COVID-19. The NAC could be more effective as prophylactic or adjuvant therapy in stable non-severe cases of COVID-19 with a particularly positive role in the augmentation of O2 saturation and faster reduction of the CRP level and inflammation.
Author’s Contributions:
All authors contributed to the preparation of data and the finalization of this article. All the figures have been produced by the authors of this article and are personal data.