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Impact of N-acetyl-l-cysteine on SARS-CoV-2 pneumonia and its sequelae: results from a large cohort study

Paola Faverio, Paola Rebora, Emanuela Rossi, Savino Del Giudice, Filippo Montanelli, Laura Garzillo, Sara Busnelli, Fabrizio Luppi, Maria Grazia Valsecchi, Alberto Pesci
ERJ Open Research 2022 8: 00542-2021; DOI: 10.1183/23120541.00542-2021
Paola Faverio
1School of Medicine and Surgery, University of Milano Bicocca, Respiratory Unit, San Gerardo Hospital, ASST Monza, Monza, Italy
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  • ORCID record for Paola Faverio
  • For correspondence: paola.faverio@unimib.it
Paola Rebora
2Bicocca Bioinformatics Biostatistics and Bioimaging B4 Center, University of Milano Bicocca, Monza, Italy
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Emanuela Rossi
2Bicocca Bioinformatics Biostatistics and Bioimaging B4 Center, University of Milano Bicocca, Monza, Italy
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Savino Del Giudice
1School of Medicine and Surgery, University of Milano Bicocca, Respiratory Unit, San Gerardo Hospital, ASST Monza, Monza, Italy
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Filippo Montanelli
1School of Medicine and Surgery, University of Milano Bicocca, Respiratory Unit, San Gerardo Hospital, ASST Monza, Monza, Italy
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Laura Garzillo
1School of Medicine and Surgery, University of Milano Bicocca, Respiratory Unit, San Gerardo Hospital, ASST Monza, Monza, Italy
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Sara Busnelli
1School of Medicine and Surgery, University of Milano Bicocca, Respiratory Unit, San Gerardo Hospital, ASST Monza, Monza, Italy
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Fabrizio Luppi
1School of Medicine and Surgery, University of Milano Bicocca, Respiratory Unit, San Gerardo Hospital, ASST Monza, Monza, Italy
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Maria Grazia Valsecchi
2Bicocca Bioinformatics Biostatistics and Bioimaging B4 Center, University of Milano Bicocca, Monza, Italy
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Alberto Pesci
1School of Medicine and Surgery, University of Milano Bicocca, Respiratory Unit, San Gerardo Hospital, ASST Monza, Monza, Italy
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Tables

  • TABLE 1

    Baseline patients’ characteristics and outcomes in the total original sample and in the pseudo-population weighted for the propensity score of N-Acetyl-l-cysteine (NAC)

    Original dataWeighted data
    NAC commencementSMDNAC commencementSMD
    NoYesNoYes
    Subjects, n321585329572
    Males192 (60)409 (70)0.213209 (64)381 (67)0.060
    Age, median (IQR)68 (57–79)63 (55–72)0.23264 (54–75)64 (55–73)0.003
    Oxygen/ventilatory support0.7360.098
     None101 (31)41 (7)49 (15)78 (14)
     Oxygen therapy alone168 (52)379 (65)193 (59)354 (62)
     CPAP51 (16)147 (25)82 (25)128 (22)
     ETI and IMV1 (0)18 (3)5 (1)12 (2)
    Cardiovascular diseases187 (58)319 (55)0.075178 (54)315 (55)0.016
    Hypertension151 (47)275 (47)0.001151 (46)270 (47)0.021
    Diabetes69 (21)84 (14)0.18753 (16)90 (16)0.006
    Obesity39 (23)126 (33)0.21953 (26)117 (33)0.156
    Cerebrovascular diseases25 (8)30 (5)0.10819 (6)36 (6)0.019
    COPD25 (8)20 (3)0.19115 (5)25 (4)0.017
    Moderate or severe chronic kidney diseases31 (10)41 (7)0.09626 (8)43 (7)0.022
    Moderate or severe liver diseases7 (2)13 (2)0.0036 (2)16 (3)0.078
    Chronic neurological disorders60 (19)52 (9)0.28741 (12)74 (13)0.014
    Cancer37 (12)47 (8)0.11833 (10)52 (9)0.030
    Immune system disorder8 (2)14 (2)0.0067 (2)12 (2)0.004
    Treatment during hospitalisation
     Systemic steroid76 (24)265 (45)0.467122 (37)217 (38)0.016
     Remdesivir13 (4)68 (12)0.28534 (10)52 (9)0.035
    Outcomes
     ICU admission20 (7)134 (23)46 (15)107 (19)0.360#
     Days to ICU, median (IQR)4 (1–6)2 (0–5)2 (0–4)2 (0–5)0.972#
     Days spent in ICU, median (IQR)9 (4–19)14 (9–24)20 (8–32)14 (9–23)0.191#
     Hospital discharge0.523#
      Death42 (13)91 (16)44 (13)91 (16)
      Discharged at home229 (71)396 (68)224 (68)392 (68)
      Transferred to other facility50 (16)98 (17)61 (19)89 (16)
    Length of hospital stay in subjects discharged at home, days, median (IQR)16 (11–25)16 (10–25)17 (12–30)15 (10–24)0.013#
    Atelectasis during hospital stay3 (1)14 (2)7 (2)11 (2)0.913#

    Data are presented as n (%), unless otherwise stated. ICU: intensive care unit; IQR: interquartile range; SMD: standardised mean difference; CPAP: continuous positive airway pressure; ETI: endotracheal intubation; IMV: invasive mechanical ventilation. #: p-values are listed for outcomes data.

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    Impact of N-acetyl-l-cysteine on SARS-CoV-2 pneumonia and its sequelae: results from a large cohort study
    Paola Faverio, Paola Rebora, Emanuela Rossi, Savino Del Giudice, Filippo Montanelli, Laura Garzillo, Sara Busnelli, Fabrizio Luppi, Maria Grazia Valsecchi, Alberto Pesci
    ERJ Open Research Jan 2022, 8 (1) 00542-2021; DOI: 10.1183/23120541.00542-2021

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    Impact of N-acetyl-l-cysteine on SARS-CoV-2 pneumonia and its sequelae: results from a large cohort study
    Paola Faverio, Paola Rebora, Emanuela Rossi, Savino Del Giudice, Filippo Montanelli, Laura Garzillo, Sara Busnelli, Fabrizio Luppi, Maria Grazia Valsecchi, Alberto Pesci
    ERJ Open Research Jan 2022, 8 (1) 00542-2021; DOI: 10.1183/23120541.00542-2021
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