N-Acetylcysteine (NAC) is a mucolytic agent but could have antioxidant and anti-inflammatory effects with higher dosage. For this reason, the use of NAC in COVID-19 has been recommended.


To evaluate the impact of using N-Acetylcysteine in the evolution of the COVID-19 infection.


A Retrospective single-center cohort study was conducted in our hospital. The inclusion criteria were to be admitted in our hospital during the first wave from March to April 2020 for COVID-19. The NAC was administrated orally with 600 mg twice a day.


A total of 378 patients were included. The gender distribution was similar (182 women, 48.1%). The average age was 73.3 14.5 years and the average stay was 7 4 days. Half of the patients (199, 52.6%) were treated with NAC and their characteristics were similar to the other group without statistically significant differences.

The global mortality was 26.7% and it was bigger in the group without NAC (p=0.013). A multivariate analysis through logistic regression identified the treatment with N-Acetylcysteine as a protective factor (OR 0.57, CI95% 0.31 ? 0.99).

In regard to the Chest-X-Ray we observed more patients in the NAC group with moderate and severe acute respiratory distress syndrome (ARDS) in the admission and a bigger improvement in the discharge.


In our study, the N-Acetylcysteine treatment in patients with COVID-19 showed a lower mortality.