1. Introduction
critically ill, dyspnea, ARDS, infection, pulmonary and cardiovascular adverse
VIRUS, CRITICALLY ILL, ARDS, INFECTION, CORONAVIRUS, SEVERE ACUTE RESPIRATORY SYNDROME, ACUTE RESPIRATORY DISTRESS SYNDROME, COMPLICATIONS
Administering N-acetylcysteine (NAC) could counteract the effect of free radicals, improving the clinical evolution of patients admitted to the Intensive Care Unit (ICU). This study aimed to investigate the clinical and biochemical effects of administering NAC to critically ill patients with COVID-19. A randomized controlled clinical trial was conducted on ICU patients (Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can cause dyspnea that can lead to acute respiratory distress syndrome (ARDS) leading to the production of a set of immune mediators against the invading virus [Glutathione plays a fundamental role in many biological processes essential for the homeostasis of the organism [N-acetylcysteine (NAC) might be beneficial for treating patients with COVID-19 because it helps restore glutathione levels, intervening in its synthesis. In addition, NAC has an antioxidant and anti-inflammatory effect and regulates the immune response. A high dose of intravenous NAC can be expected to play an adjunctive role in treating severe cases of COVID-19 and managing its lethal complications, including pulmonary and cardiovascular adverse events [Several studies showed that the increase in neutrophils and neutrophil extracellular traps (NETs) in COVID-19 patients contribute to increasing severity and mortality. Therefore, they can be used as therapeutic targets [The intervention with NAC was used successfully in patients with invasive mechanical ventilation, observing a decrease in ferritin and C-reactive protein (CRP) [Based on the information mentioned above, the present study proposes that the administration of NAC could counteract the effect of these free radicals, improving the antioxidant status and inflammatory situation and, therefore, the clinical evolution of the COVID-19 patient in the ICU. The main objective of our study was to investigate the clinical and biochemical effects of administering NAC to critically ill patients with COVID-19.