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The Potential of Melatonin and N-Acetylcysteine on Remdesivir Induced Liver Injury in Covid 19 Patients

The Potential of Melatonin and N-Acetylcysteine on Remdesivir Induced Liver Injury in Covid 19 Patients

Seyedmohammad Karimi1, Mohammad Darvishi2*, Mohammad Barati3, Ramin Hamidi Frahani4, Mohammad Hassan Kazemi5

1Researcher and General practitioner, Infectious Diseases Research Center, Aja University of Medical Sciences, Tehran, Iran; 2Faculty of Aerospace and Subaquatic Medicine, AJA University of Medical Sciences, Tehran, Iran; 3Infectious Diseases Research Center, AJA University of Medical Sciences, Tehran, Iran; 4Department of Infectious diseases, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran; 5Department of Medical Epidemiology, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran.

 
*Correspondence | Mohammad Darvishi, Faculty of Aerospace and Subaquatic Medicine, AJA University of Medical Sciences, Tehran, Iran; Email: mohamdarvishii@gmail.com

ABSTRACT

The Covid-19 pandemic has been a problem in recent years. The first FDA approved drug in the treatment of this disease was Remdesivir, which, despite its many benefits, has harmful effects on the liver. Melatonin and N-acetylcysteine, two drugs that have previously been shown to protect the liver with their antioxidant properties, may reduce the hepatic toxicity induced by Remdesivir. Given that few studies have been performed on the role of oral melatonin and N-acetylcysteine on reducing the hepatic adverse effects of Remdesivir, we decided to conduct this clinical trial study. In this double-blind, randomized clinical trial study, 70 patients with Covid-19 in Besat Hospital, Tehran, Iran, during 2022, were enrolled. Patients were randomly divided into two groups of 35 each. Both groups were administered Remdesivir with same protocol. In this period, the first group received N-acetylcysteine 600 mg tablet twice daily and melatonin 6 mg tablet at bedtime. The second group received placebos with the same appearance. Liver enzymes of all patients were serially evaluated and then demographic and lab datas were extracted. Mann-Whitney test, Chi-square test and independent t-test were used for analysis of data. P < 0.05 was considered statistically significant. No significant difference was seen between case and control groups regarding age, gender, BMI and severity of the disease at the time of hospital admission (P > 0.05), which shows a random classification of two groups. The mean AST, ALT, ALP and CBC of patients in case group decreased compared to the control group but the difference was not statistically significant (P > 0.05). In patients with COVID-19 that received Remdesivir, oral administration of melatonin and NAC did not significantly decrease either the patients liver enzymes or CBC level in 6 day of enrolment compared with placebo. Further studies with longer duration and different doses are recommended.
 
Keywords | Remdesivir, Melatonin, N-acetyl cysteine, Liver injury, Covid-19

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Advances in Animal and Veterinary Sciences

June

Vol. 12, Iss. 6, pp. 994-1205

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