Effects of nebulized hypertonic saline on inflammatory mediators in patients with severe COVID-19 pneumonia: A double-blinded randomized controlled trial
Mohammad-Taghi Beigmohammadi, Laya Amoozadeh, Nikoosadat Naghibi, Babak Eslami, Samrand Fattah Ghazi, Mohammad Javaherian, Mohammad-Amin Khajeh-Azad, Bahram Tabatabaei, Alireza Abdollahi, Elham Nazar
Science Progress, doi:10.1177/00368504231203130
Introduction: An exaggerated immune response is considered the most important aspect of COVID-19 pathogenesis. Hypertonic saline (HS) has shown promise in combating inflammation in several respiratory diseases. We investigated the effects of nebulized HS on clinical symptoms and inflammatory status in patients with severe novel coronavirus infection (COVID-19) pneumonia.
Declaration of conflicting interests The authors declared no potential conflicts of interest with respect to the research, authorship, and/ or publication of this article.
Ethics approval This trial was approved by the Ethical Committee of the Tehran University of Medical Sciences (TR.TUMS.IKHC.REC.1400.016).
Research registration number The study was registered at www.irct.ir (registration number: IRCT20120216009045N4).
Author biographies Mohammad-Taghi Beigmohammadi is a professor of anesthesiology and intensive care and is a fellowship of critical care medicine. He is head of the ICU at Imam Khomeini Complex Hospital. Laya Amoozadeh has a Ph.D. in physiotherapy and works and research in the school of rehabilitation at Tehran University of Medical Sciences. Nikoosadat Naghibi is an assistant professor of anesthesiology at Abadan University of Medical Sciences and works in the ICU. Babak Eslami is an assistant professor of anesthesiology and research on pulmonary diseases.
Samrand Fattah Ghazi is an assistant professor of anesthesiology and research on viral pulmonary infections and treatment. Mohammad Javaherian has a Ph.D. in physiotherapy and works and research in the school of rehabilitation at Tehran University of Medical Sciences. Mohammad-Amin Khajeh-Azad is a general practitioner and does statistical analysis as a consultant. Bahram Tabatabaei has a Ph.D. in physiotherapy and works and research in the school of rehabilitation at Tehran University of Medical..
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DOI record:
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"abstract": "<jats:sec><jats:title>Introduction:</jats:title><jats:p> An exaggerated immune response is considered the most important aspect of COVID-19 pathogenesis. Hypertonic saline (HS) has shown promise in combating inflammation in several respiratory diseases. We investigated the effects of nebulized HS on clinical symptoms and inflammatory status in patients with severe novel coronavirus infection (COVID-19) pneumonia. </jats:p></jats:sec><jats:sec><jats:title>Materials and Methods:</jats:title><jats:p> We randomly assigned 60 adults admitted to the intensive care unit (ICU) due to severe COVID-19 pneumonia to the experimental (received nebulized 5% saline) and control (received nebulized distilled water) groups. All interventions were applied 4 times daily for 5 days. The levels of tumor necrosis factor-α (TNF-α), interleukin 6 (IL-6), and other clinical factors from venous blood were evaluated before and after intervention application. Mortality rate, intubation rate, and durations of ICU and hospital stay were also compared between groups. </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> The levels of TNF-α (MD: −21.35 [−32.29, −10.40], P = 0.000) and IL-6 (−9.94 [−18.86, −1.02], P = 0.003) were lower in the experimental group compared to the control group after applying the interventions. The levels of white blood cell count, PO<jats:sub>2</jats:sub>, and serum sodium were also statistically significant differences between groups. However, we did not observe significant differences in terms of hospitalization durations and mortality rates. </jats:p></jats:sec><jats:sec><jats:title>Conclusion:</jats:title><jats:p> Nebulization of HS in patients with severe COVID-19 pneumonia appears to be effective in reducing inflammation, but does not appear to affect intubation rates, mortality, hospitalization, or length of stay in ICU. </jats:p></jats:sec>",
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