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Role of Sodium Bicarbonate as Adjuvant Treatment of Nonsevere Computed Tomography-identified COVID-19 Pneumonia: A Preliminary Report

El-Badrawy et al., Indian Journal of Respiratory Care, doi:10.4103/ijrc.ijrc_48_21, NCT04374591
Jun 2022  
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Mortality 57% Improvement Relative Risk Progression 39% Recovery 19% CT score 73% Recovery time 66% Alkalinization  El-Badrawy et al.  LATE TREATMENT Is late treatment with alkalinization beneficial for COVID-19? Prospective study of 182 patients in Egypt (April - August 2020) Improved recovery with alkalinization (p=0.034) c19early.org El-Badrawy et al., Indian J. Respirato.., Jun 2022 Favorsalkalinization Favorscontrol 0 0.5 1 1.5 2+
28th treatment shown to reduce risk in November 2021, now with p = 0.0000000046 from 14 studies.
No treatment is 100% effective. Protocols combine treatments.
5,000+ studies for 109 treatments. c19early.org
Prospective study of 182 COVID-19 pneumonia patients, 127 treated with sodium bicarbonate inhalation and nasal drops, showing significantly faster recovery and improved CT scores with treatment.
Authors note that contacts of index cases also received sodium bicarbonate treatment, with none reporting COVID-19.
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).
Targeted administration to the respiratory tract provides treatment directly to the typical source of initial SARS-CoV-2 infection and replication, and allows for rapid onset of action and reduced systemic side effects (early treatment may be more beneficial).
risk of death, 56.7% lower, RR 0.43, p = 0.37, treatment 3 of 127 (2.4%), control 3 of 55 (5.5%), NNT 32.
risk of progression, 39.4% lower, RR 0.61, p = 0.52, treatment 7 of 127 (5.5%), control 5 of 55 (9.1%), NNT 28, deterioration or death, day 30.
risk of no recovery, 19.2% lower, RR 0.81, p = 0.03, treatment 84 of 127 (66.1%), control 45 of 55 (81.8%), NNT 6.4, day 30.
relative CT score, 72.7% better, RR 0.27, p < 0.001, treatment 127, control 55, day 30.
recovery time, 66.2% lower, relative time 0.34, p < 0.001, treatment mean 3.31 (±0.99) n=127, control mean 9.79 (±6.29) n=55, time to clinical improvement.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
El-Badrawy et al., 12 Jun 2022, prospective, Egypt, peer-reviewed, 7 authors, study period 15 April, 2020 - 31 August, 2020, trial NCT04374591 (history).
This PaperAlkalinizationAll
Role of Sodium Bicarbonate as Adjuvant Treatment of Nonsevere Computed Tomography-identified COVID-19 Pneumonia: A Preliminary Report
Abdelbaset Mohammad Khairy El-Badrawy, Mohamed Saleh, Adel El-Badrawy, Ali Tamer, Mohamed Abd El-Hadidy, Ellatif, Dr Rehab Ahmad Elmorsey, Ahmed A Shokeir
doi:10.4103/ijrc.ijrc_48_21
when China reported the first cluster of cases with a novel coronavirus COVID-19, the disease has been rapidly transmitted to almost all countries worldwide. [1, 2] Owing to the absence of definitive treatment options of COVID-19, investigating alternative adjuvant treatments is appropriate until production of a specific effective medication. The suggestion that sodium bicarbonate (SB) could help to restrain coronavirus 2 (SARS-CoV-2) infection is based upon its anti-influenza properties and its widespread use during the "Spanish flu" pandemic of 1918. SB solution 8.4% is sterile, with a pH >8.6, nonpyrogenic, and is used for the treatment of metabolic acidosis. Bronchoalveolar lavage with SB 8.4% is inhibitory to bacteria, fungi, and tuberculosis in cultures. [3] [4] [5] SB is also a disinfectant against feline calicivirus and coxsackievirus. [6, 7] The severity of COVID-19 in adults is clinically classified into mild, moderate, severe, and critical disease according to the WHO interim guidelines published on May 2020. [8, 9] The location of care as recommended by the WHO depends on the epidemiologic scenario and should be either at a designated COVID-19 health facility, community facility, or where not possible, at home. [10] In the present study, we aimed at investigating the role of SB 8.4% as adjuvant therapy in the treatment of patients with moderate clinical stage and moderate radiological chest
Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.
References
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Sturman, Ricard, Holmes, Conformational change of the coronavirus peplomer glycoprotein at pH 8.0 and 37 degrees C correlates with virus aggregation and virus-induced cell fusion, J Virol
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Zheng, Huang, Yin, Zhang, Ye et al., Comparative study of the lymphocyte change between COVID-19 and non-COVID-19 pneumonia cases suggesting uncontrolled inflammation might not be the main reason of tissue injury, medRxiv
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Late treatment
is less effective
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