TY - JOUR
T1 - Is N -acetylcysteine effective in treating patients with coronavirus disease 2019? A meta-analysis
AU - Chen, Chih Hao
AU - Hung, Kai Feng
AU - Huang, Chii Yuan
AU - Leong, Jing Li
AU - Chu, Yuan Chia
AU - Chang, Chun Yu
AU - Wang, Mong Lien
AU - Chiou, Shih Hwa
AU - Cheng, Yen Fu
N1 - Publisher Copyright:
© 2023 Wolters Kluwer Health. All rights reserved.
PY - 2023/3/1
Y1 - 2023/3/1
N2 - Background: Coronavirus disease 2019 (COVID-19) is a global pandemic caused by severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2). It has brought tremendous challenges to public health and medical systems around the world. The current strategy for drug repurposing has accumulated some evidence on the use of N-acetylcysteine (NAC) in treating patients with COVID-19. However, the evidence remains debated. Methods: We performed the systematic review and meta-analysis that complies with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Five databases and reference lists were searched from inception to May 14, 2022. Studies evaluating the efficacy of NAC in treating patients with COVID-19 were regarded as eligible. The review was registered prospectively on PROSPERO (CRD42022332791). Results: Of 778 records identified from the preliminary search, four studies were enrolled in the final qualitative review and quantitative meta-analysis. A total of 355 patients were allocated into the NAC group and the control group. The evaluated outcomes included intubation rate, improvement, duration of intensive unit stay and hospital stay and mortality. The pooled results showed nonsignificant differences in intubation rate (OR, 0.55; 95% CI, 0.16-1.89; p = 0.34; I2= 75%), improvement of oxygenation ([MD], 80.84; 95% CI, -38.16 to 199.84; p = 0.18; I2= 98%), ICU stay (MD, -0.74; 95% CI, -3.19 to 1.71; p = 0.55; I2= 95%), hospital stay (MD, -1.05; 95% CI, -3.02 to 0.92; p = 0.30; I2= 90%), and mortality (OR, 0.58; 95% CI, 0.23-1.45; p = 0.24; I2= 54%). Subsequent trial sequential analysis (TSA) showed conclusive nonsignificant results for mortality, while the TSA for the other outcomes suggested that a larger sample size is essential. Conclusions: The current evidence reveals NAC is not beneficial for treating patients with COVID- 19 with regard to respiratory outcome, mortality, duration of ICU stay and hospital stay.
AB - Background: Coronavirus disease 2019 (COVID-19) is a global pandemic caused by severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2). It has brought tremendous challenges to public health and medical systems around the world. The current strategy for drug repurposing has accumulated some evidence on the use of N-acetylcysteine (NAC) in treating patients with COVID-19. However, the evidence remains debated. Methods: We performed the systematic review and meta-analysis that complies with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Five databases and reference lists were searched from inception to May 14, 2022. Studies evaluating the efficacy of NAC in treating patients with COVID-19 were regarded as eligible. The review was registered prospectively on PROSPERO (CRD42022332791). Results: Of 778 records identified from the preliminary search, four studies were enrolled in the final qualitative review and quantitative meta-analysis. A total of 355 patients were allocated into the NAC group and the control group. The evaluated outcomes included intubation rate, improvement, duration of intensive unit stay and hospital stay and mortality. The pooled results showed nonsignificant differences in intubation rate (OR, 0.55; 95% CI, 0.16-1.89; p = 0.34; I2= 75%), improvement of oxygenation ([MD], 80.84; 95% CI, -38.16 to 199.84; p = 0.18; I2= 98%), ICU stay (MD, -0.74; 95% CI, -3.19 to 1.71; p = 0.55; I2= 95%), hospital stay (MD, -1.05; 95% CI, -3.02 to 0.92; p = 0.30; I2= 90%), and mortality (OR, 0.58; 95% CI, 0.23-1.45; p = 0.24; I2= 54%). Subsequent trial sequential analysis (TSA) showed conclusive nonsignificant results for mortality, while the TSA for the other outcomes suggested that a larger sample size is essential. Conclusions: The current evidence reveals NAC is not beneficial for treating patients with COVID- 19 with regard to respiratory outcome, mortality, duration of ICU stay and hospital stay.
KW - COVID-19
KW - Meta-analysis
KW - N -acetylcysteine
KW - Treatment
UR - http://www.scopus.com/inward/record.url?scp=85149939554&partnerID=8YFLogxK
U2 - 10.1097/JCMA.0000000000000869
DO - 10.1097/JCMA.0000000000000869
M3 - Article
C2 - 36728396
AN - SCOPUS:85149939554
SN - 1726-4901
VL - 86
SP - 274
EP - 281
JO - Journal of the Chinese Medical Association
JF - Journal of the Chinese Medical Association
IS - 3
ER -
