Abstract: A randomized controlled trial of adjuvant inhalable sodium bicarbonate role in treatment of COVID-19 Mohammad El-Badrawy Faculty of Medicine, Mansoura University Rehab Elmorsey Faculty of Medicine, Mansoura University Mohammed shehta Faculty of Medicine, Mansoura University Tamer El-Hadidy Faculty of Medicine, Mansoura University ibrahim abdelwahab (  dribrahim_badr@yahoo.com ) Faculty of Medicine, Mansoura University Adel El-Badrawy Faculty of Medicine, Mansoura University Ahmed Shokeir Faculty of Medicine, Mansoura University Article Keywords: Covid-19, sodium bicarbonate, human, RCT Posted Date: November 18th, 2022 DOI: https://doi.org/10.21203/rs.3.rs-2214180/v1 License:   This work is licensed under a Creative Commons Attribution 4.0 International License. Read Full License Page 1/14 Abstract Entry of coronavirus (SARS-CoV-2) into a host cell is pH dependent. Intracellular alkalinization by sodium bicarbonate (SB) could elevate endosomal pH and block viral entry into the host cells. So, we assessed the role of inhalable SB as an adjuvant treatment for COVID-19 in the study groups of this randomized, controlled trial. Here we show a significantly shorter duration to clinical improvement and hospital stay in the study group, while the number of deaths is significantly less only in severe grade of the study group. But the time to death is not significantly different in both groups. CRP and d-dimer levels are significantly lower in the severe cases of the study group. The overall median CT score is significantly better in the study group at one & 2 months. Our data thus suggest that inhaled SB (8.4%) could be a possible adjuvant therapy for patients with moderate and severe COVID‑19 pneumonia.