Evaluation of the efficacy and safety of oral N-acetylcysteine in treatment and recovery of patients with COVID-19 who are under treatment with routine protocols
Evaluation of the efficacy and side effects of N-Acetyl Cysteine in the treatment and recovery of patients with COVID-19 in Hazrat Rasool Akram Hospitals: A Randomize Clinical Trial
Design
Clinical trial with control group, with parallel groups, double-blind, randomized, phase 3 on 60 patients. The rand function of the Excel software was used for randomization.
inclusion|:hospitalized patients with moderate to severe COVID-19 with stable vital signs
exclusion: Patients with unstable vital signs or need for intubation/Patients hospitalized in ICU/ history of hypersensitivity to NAC/pregnancy,lactation and infancy
Intervention groups
Treatment in both control and intervention groups is based on the use of common treatment protocols in patients with covid-19. In the intervention group,oral NAC is added to the routine treatment
Main outcome variables
fever/cough/dyspenia/o2 level/duration of administration/laboratory parameters/ radiologic changes/ICU admission/death
General information
Reason for update
Acronym
NAC
IRCT registration information
IRCT registration number:IRCT20200623047897N1
Registration date:2020-08-16, 1399/05/26
Registration timing:registered_while_recruiting
Last update:2020-08-16, 1399/05/26
Update count:0
Registration date
2020-08-16, 1399/05/26
Registrant information
Name
Najmolsadat Atefi
Name of organization / entity
Country
Iran (Islamic Republic of)
Phone
+98 21 8857 4388
Email address
atefi.ns@iums.ac.ir
Recruitment status
Recruitment complete
Funding source
Expected recruitment start date
2020-05-21, 1399/03/01
Expected recruitment end date
2020-08-22, 1399/06/01
Actual recruitment start date
empty
Actual recruitment end date
empty
Trial completion date
empty
Scientific title
Evaluation of the efficacy and safety of oral N-acetylcysteine in treatment and recovery of patients with COVID-19 who are under treatment with routine protocols
Public title
Efficacy of N-acetylcysteine in patients with COVID-19
Purpose
Treatment
Inclusion/Exclusion criteria
Inclusion criteria:
admitted patients with COVID-19
moderate to severe, stable patients
Exclusion criteria:
unstable and intubated ICU patients
pregnancy, breastfeeding infancy
allergy and intolerance to NAC
unstable vital signs or need for intubation
Age
No age limit
Gender
Both
Phase
3
Groups that have been masked
No information
Sample size
Target sample size:
60
Randomization (investigator's opinion)
Randomized
Randomization description
In this study, participants were classified by stratified blocked randomization method based on easy sampling method and based on therapeutic regimen (four regimens) and were randomly assigned to one of the groups receiving the intervention (routine treatment regimen+NAC) or the routine treatment regimen alone group. Randomization is done separately within each group. The size of the blocks is 4, with two allocations to the intervention group (A) and two allocations to the routine treatment group (B), which will create 6 different formats as BAAB, ABBA, ABAB, AABB, BABA, BBAA.
Blinding (investigator's opinion)
Not blinded
Blinding description
Placebo
Not used
Assignment
Parallel
Other design features
Secondary Ids
empty
Ethics committees
1
Ethics committee
Name of ethics committee
Ethics committee of Iran University of medical scinces
Street address
Hazrat Rasool akram hospital, Mansoori ave, Sattarkhan street
City
Teharn
Province
Tehran
Postal code
۱۴۴۵۶۱۳۱۳۱
Approval date
2020-05-10, 1399/02/21
Ethics committee reference number
IR.IUMS.REC.1399.206
Health conditions studied
1
Description of health condition studied
covid-19
ICD-10 code
U07.1
ICD-10 code description
COVID-19
Primary outcomes
1
Description
Time to improve symptoms such as cough, shortness of breath and lethargy
Timepoint
At the beginning of the hospitalization/ two weeks after treatment
Method of measurement
clinical evaluation
2
Description
O2 saturation
Timepoint
At the beginning of the hospitalization/ two weeks after treatment
Method of measurement
clinical evaluation and pulse oximetery
3
Description
Re-hospitalization after discharge
Timepoint
At the beginning of the hospitalization/ two weeks after treatment
Method of measurement
clinical evaluation
4
Description
duration of hospitalization
Timepoint
after discharge
Method of measurement
days
5
Description
Evaluation of laboratory parameters as a series of factors: PCR and LDH, CBC, ESR, CRP Comparison of parameters at the beginning of hospitalization, during hospitalization and at the time of discharge
Timepoint
At the beginning of the hospitalization/ during hospitalization/ at discharge time
Method of measurement
lab data analysis
6
Description
Check for changes in anti-inflammatory parameters (TNF-ALPHA and IL-6 if measuring kits are available)
Timepoint
At the beginning of the hospitalization/ at discharge time
Method of measurement
lab data analysis
7
Description
Investigation of radiological changes at the beginning of hospitalization and during hospitalization if possible
Timepoint
At the beginning of the hospitalization/ during hospitalization
Method of measurement
radiographic changes
8
Description
ICU admission
Timepoint
during hospitalization
Method of measurement
clinical evaluation
9
Description
recovery or death
Timepoint
during hospitalization and after discharge
Method of measurement
clinical evaluation
Secondary outcomes
1
Description
side effects
Timepoint
Time to start the intervention/ during hospitalization, two weeks after interventions
Method of measurement
Clinical, laboratory evaluation
2
Description
need change initial treatment or add new drug to the regimen
Timepoint
during hospitalization
Method of measurement
clinical assessment
Intervention groups
1
Description
Intervention group: hospitalized patients with moderate-sever covid-19 with stable vital signs who receive NAC. In this study, for each specific routine therapeutic regimen (regimen 1: kaletra+ hydroxychloroquine and regimen 2: atazanavir / ritonavir + hydroxychloroquine), two arms of 15 people are defined (15 people in the control group who will receive only the routine regimen and 15 people in the intervention group who will receive 600 mg oral NAC three times a day in addition to the routine regimen).
Category
Treatment - Drugs
2
Description
Control group: hospitalized patients with moderate-sever covid-19 with stable vital signs who do not receive the NAC (N-acetyl cysteine) In this study, for each specific routine therapeutic regimen (regimen 1: kaletra+ hydroxychloroquine and regimen 2: atazanavir / ritonavir + hydroxychloroquine), two arms of 15 people are defined (15 people in the control group who will receive only the routine regimen and 15 people in the intervention group who will receive 600 mg oral NAC three times a day in addition to the routine regimen).
Category
Treatment - Drugs
Recruitment centers
1
Recruitment center
Name of recruitment center
Hazrate Rasool Akram Hospital
Full name of responsible person
Najmolsadat Atefi
Street address
Hazrate Rasool Akram Hospital, Mansoori ave, Sattarkhan street
City
Tehran
Province
Tehran
Postal code
۱۴۴۵۶۱۳۱۳۱
Phone
+98 21 6651 6001
Email
atefi.ns@iums.ac.ir
Web page address
https://hrmc.iums.ac.ir/
Sponsors / Funding sources
1
Sponsor
Name of organization / entity
Iran University of Medical Sciences
Full name of responsible person
Dr. Seyyed Abbas Motevalian
Street address
Iran University of Medical Sciences, Shahid Hemmat Highway
City
Tehran
Province
Tehran
Postal code
1449614535
Phone
+98 21 8670 2503
Fax
+98 21 8862 2307
Email
research-m@iums.ac.ir
Web page address
https://vcr.iums.ac.ir
Grant name
Grant code / Reference number
Is the source of funding the same sponsor organization/entity?
Yes
Title of funding source
Iran University of Medical Sciences
Proportion provided by this source
100
Public or private sector
Public
Domestic or foreign origin
Domestic
Category of foreign source of funding
empty
Country of origin
Type of organization providing the funding
Academic
Person responsible for general inquiries
Contact
Name of organization / entity
Iran University of Medical Sciences
Full name of responsible person
Najmolsadat Atefi
Position
Associate professor
Latest degree
Specialist
Other areas of specialty/work
Dermatology
Street address
Dermatology ward, Hazrate Rasoole Akram Hospital, Niayesh St, Satarkhan Av
City
Tehran
Province
Tehran
Postal code
14665354
Phone
00982164351
Email
atefi.ns@iums.ac.ir
Person responsible for scientific inquiries
Contact
Name of organization / entity
Iran University of Medical Sciences
Full name of responsible person
Najmolsadat Atefi
Position
Associate professor
Latest degree
Specialist
Other areas of specialty/work
Dermatology
Street address
Dermatology ward, Hazrate Rasoole Akram Hospital, Niayesh St, Satarkhan Av
City
Tehran
Province
Tehran
Postal code
14665354
Phone
00982164351
Email
atefi.ns@iums.ac.ir
Person responsible for updating data
Contact
Name of organization / entity
Iran University of Medical Sciences
Full name of responsible person
Niloufar Najar Nobari
Position
assistant professor
Latest degree
Specialist
Other areas of specialty/work
Dermatology
Street address
Hazratb rasool akram hospital, mansoori ave, sattarkhan street
City
Tehran
Province
Tehran
Postal code
۱۴۴۵۶۱۳۱۳۱
Phone
+98 21 6651 6001
Email
niloofar.nobari@yahoo.com
Sharing plan
Deidentified Individual Participant Data Set (IPD)
Undecided - It is not yet known if there will be a plan to make this available
Study Protocol
Undecided - It is not yet known if there will be a plan to make this available
Statistical Analysis Plan
Undecided - It is not yet known if there will be a plan to make this available
Informed Consent Form
Undecided - It is not yet known if there will be a plan to make this available
Clinical Study Report
Undecided - It is not yet known if there will be a plan to make this available
Analytic Code
Undecided - It is not yet known if there will be a plan to make this available