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0 0.5 1 1.5 2+ Mortality 23% Improvement Relative Risk Mortality, exc. critical 55% Mortality, moderate 79% Mortality, severe 53% Mortality, critical -23% Recovery time 28% CT score, day 30 33% CT score, day 60 100% El-Badrawy et al. NCT05035524 Alkalinization RCT LATE Is late treatment with alkalinization beneficial for COVID-19? RCT 546 patients in Egypt (September 2021 - April 2022) Faster recovery with alkalinization (p<0.000001) Lower mortality for non-critical patients (p=0.02) El-Badrawy et al., Research Square, doi:10.21203/ Favors alkalinization Favors control
A randomized controlled trial of adjuvant inhalable sodium bicarbonate role in treatment of COVID-19
El-Badrawy et al., Research Square, doi:10.21203/ (Preprint), NCT05035524 (history)
El-Badrawy et al., A randomized controlled trial of adjuvant inhalable sodium bicarbonate role in treatment of COVID-19, Research Square, doi:10.21203/ (Preprint), NCT05035524
Nov 2022   Source   PDF  
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RCT 546 patients showing significantly faster recovery and lower mortality with sodium bicarbonate (inhaled and nasal drops). The reduction in mortality is only statistically significant when excluding baseline critical cases.
Inhalation of nebulized sodium bicarbonate 8.4% (5ml every 4h) 7:00am to 23:00pm every day for 30 days together with 8.4% nasal drops 4 times daily (three drops for each nostril).
risk of death, 23.2% lower, RR 0.77, p = 0.26, treatment 32 of 272 (11.8%), control 42 of 274 (15.3%), NNT 28, all cases.
risk of death, 54.8% lower, RR 0.45, p = 0.02, treatment 12 of 247 (4.9%), control 27 of 251 (10.8%), NNT 17, mild/moderate/severe cases.
risk of death, 79.2% lower, RR 0.21, p = 0.21, treatment 1 of 125 (0.8%), control 5 of 130 (3.8%), NNT 33, moderate cases.
risk of death, 53.2% lower, RR 0.47, p = 0.02, treatment 11 of 63 (17.5%), control 22 of 59 (37.3%), NNT 5.0, severe cases.
risk of death, 22.7% higher, RR 1.23, p = 0.33, treatment 20 of 25 (80.0%), control 15 of 23 (65.2%), critical cases.
recovery time, 27.6% lower, relative time 0.72, p < 0.001, treatment mean 4.2 (±2.5) n=272, control mean 5.8 (±3.1) n=274, time to clinical improvement.
CT score, 33.3% lower, RR 0.67, p = 0.001, treatment 238, control 229, CT score, day 30.
CT score, 100% lower, RR < 0.001, p < 0.001, treatment 238, control 229, CT score, day 60.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
El-Badrawy et al., 18 Nov 2022, Randomized Controlled Trial, Egypt, preprint, 7 authors, study period 1 September, 2021 - 30 April, 2022, trial NCT05035524 (history).
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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 (  ) 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: 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.
Late treatment
is less effective
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