Is N -acetylcysteine effective in treating patients with coronavirus disease 2019? A meta-analysis

Chih Hao Chen, Kai Feng Hung, Chii Yuan Huang, Jing Li Leong, Yuan Chia Chu, Chun Yu Chang, Mong Lien Wang, Shih Hwa Chiou, Yen Fu Cheng*

*此作品的通信作者

研究成果: Article同行評審

3 引文 斯高帕斯(Scopus)

摘要

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.

原文English
頁(從 - 到)274-281
頁數8
期刊Journal of the Chinese Medical Association
86
發行號3
DOIs
出版狀態Published - 1 3月 2023

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