N-Acetylcysteine Treatment Accelerates Patient-Reported Outcomes Improvement in Patients With COVID-19 A Prospective Study (preprint)

ABSTRACT

Background: Since its outbreak in late December 2019, the coronavirus disease 2019 (COVID-19) has culminated in a global pandemic, and its causative virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has continued to mutate, with increasing rates of transmission and pathogenicity, having a serious worldwide impact. This study aims to assess the benefits of the health-related quality of life of using N-acetylcysteine(NAC).Methods: In this prospective observational research, 63 confirmed COVID-19 patients who were treated between the ends of January and March 2020 were divided into patients treated with NAC-treatment (32 cases) and non-NAC-treatment groups (31 cases). Patients were followed up at discharge and at 1, 3, and 6 months after discharge. The clinical treatment effects of the two groups were compared, and the St. George’s Respiratory Questionnaire (SGRQ) evaluated patient-reported outcomes.Results: There were strong correlations between SGRQ component scores (0.728, 0.749, 0.850; P < 0.001 for all items) as well as between each SGRQ component score and the total patient score (0.822, 0.958, 0.957; P < 0.001 for all items). In the univariate analysis, the change differences of one month after discharge compared with discharge between two groups patients were statistically significant in the impacts and total scores (753.000, P < 0.001; 644.000, P = 0.042); the change differences of three months after discharge compared with discharge were also significant in the activity, impacts, and total scores (660.500, P = 0.022; 800.000, P < 0.001; 707.000, P = 0.004). In the multivariate analysis, the factors that have statistically significant influence on the unit value of SGRQ total score difference (UVDSGRQ) is NAC treatment (β = 1.954, P < 0.001), disease severity (β = 3.179, P < 0.001), follow-up duration (β = -0.232, P = 0.001), as well as NAC treatment and follow-up duration interaction item (β = -0.436, P = 0.004).Conclusion: Our study shows as the follow-up time increases, the SGRQ total scores of patients treated with NAC decreases significantly faster than those who were treated without NAC. In the treatment of COVID-19 patients, increasing the use of NAC has clinical significance.