Prospective Randomized Double-blind Placebo-controlled Study to Assess the Effects of Nano-ozonized Hydrogen Peroxide Nebulization on Results of RTPCR for Novel Coronavirus thus Infectivity and Clinical Course among Moderately Sick COVID-19 Patients

Importance: Given the high mortality and cost of health care, especially in isolation settings, the idea of using nebulized hydrogen peroxide may play a very significant role in inactivation of coronavirus, thus reducing the infectivity period leading to reduced requirement of isolation and improving morbidity and mortality in people suffering with coronavirus disease-2019 (COVID-2019). Aim and objective: Objective of this study was to determine the efficiency of nebulized hydrogen peroxide (H 2 O 2 ) in reducing the viral load and disease severity of patients suffering with COVID-19. Design: Double-blinded randomized control trial. HOPE in COVID-19 study. Setting: Tertiary care COVID hospital (single center). Participants: Moderate sick COVID-19-positive patients were included in the study after they qualified the inclusion criteria. Intervention: Patients were nebulized using 1 mL of ozonized H 2 O 2 after diluting with 4 mL of normal saline three times a day for 5 days. The control group was nebulized with normal saline only. Main outcome: Outcome was assessed for reduction in oxygen requirement (number of days on oxygen), symptoms resolution (dyspnea, cough, and fever), and number of days it took to be RT-PCR negative for COVID-19. Results: The early data from trial showed promising trends toward a better outcome. The study showed that in the case group who were nebulized with hydrogen peroxide resulted in better outcome in terms of parameters assessed in the study and the differences from the control group were statistically significant (p ≤0.001, CI 95%). Outcome in the form of mortality (odds ratio 0.29, 95% CI 0.02-3.14, p = 0.31, z = 1.007) was statistically insignificant. The number needed to treat for our study was 10.