COVID-19 Mortality Reduction through N-Acetylcysteine Therapy: Systematic Review and Meta-Analysis

Strategic Insights -

Researchers from Monash University Malaysia have conducted a systematic review and meta-analysis of randomized controlled trials evaluating the effect of N-acetylcysteine (NAC) on mortality in patients with COVID-19. The study, published in the journal Inflammopharmacology, aimed to provide a comprehensive assessment of the available evidence on the use of NAC as an adjunctive therapy for COVID-19. According to the research, NAC regimens varied by dose and route, and the pooled odds ratio for mortality was 0.49 (95% CI: 0.25-0.94; I = 67%), indicating a 51% reduction in the odds of death among patients receiving NAC.

Key Takeaways:

  • The systematic review and meta-analysis included 10 randomized controlled trials (RCTs) comprising 1,424 patients with COVID-19.
  • NAC regimens varied by dose and route, with some studies administering NAC at higher doses or via non-oral routes.
  • The pooled odds ratio for mortality was 0.49 (95% CI: 0.25-0.94; I = 67%), indicating a 51% reduction in the odds of death among patients receiving NAC.
  • Seven studies had low risk of bias, while three had some concerns due to open-label designs.
  • Further large-scale RCTs are needed to confirm the findings and establish optimal dosing and administration strategies.
  • The study's lead author, Dinesh Sangarran Ramachandram, emphasized the need for further research to confirm the efficacy of NAC as an adjunctive therapy for COVID-19.

Statistics:

  • 51% reduction in the odds of death among patients receiving NAC (pooled OR: 0.49 (95% CI: 0.25-0.94; I = 67%))
  • 10 RCTs comprising 1,424 patients with COVID-19 were included in the systematic review and meta-analysis.
  • 7 studies had low risk of bias, while 3 had some concerns due to open-label designs.
  • The study's researchers noted that further large-scale RCTs are needed to confirm the findings and establish optimal dosing and administration strategies.

Sources:

  • NewsRx LLC, "Researchers at Monash University Malaysia Report New Data on COVID-19 (Effect of N-Acetylcysteine on mortality in COVID-19 patients: A systematic review and meta-analysis of randomized controlled trials). Chemicals & Chemistry, August 15, 2025; p 124.
  • Inflammopharmacology, "Effect of N-Acetylcysteine on mortality in COVID-19 patients: A systematic review and meta-analysis of randomized controlled trials," 2025.
  • Springer Basel Ag, Picassoplatz 4, Basel, 4052, Switzerland (www.springer.com; www.springerlink.com/content/0925-4692/)