Alkalinization Using Sodium Bicarbonate for COVID-19 Treatment: A Systematic Review and Meta-Analysis
MD Arman Shafiee, MD Kyana Jafarabady, MD Hassan Moltazemi, MD Mohammad Javad Amini, MD Mohammad Ali Rafiei, MD Amirhossein Akhondi, PhD Sayed-Hamidreza Mozhgani
Journal of Evidence-Based Integrative Medicine, doi:10.1177/2515690x241258403
Background: A systematic review and meta-analysis have been conducted to evaluate the efficacy of alkalinization for COVID-19 patients based on current evidence to determine the impact of alkalinization on COVID-19 outcomes. Methods: We searched MEDLINE (Pubmed), Web of Science, Cochrane Library, and Clinicaltrials.gov for studies evaluating the efficacy of alkalinization up to 30 April 2023. Based on the PRISMA 2020 statement criteria a systematic review and meta-analysis of studies were performed. Results: The results of our meta-analysis showed a significant reduction in mortality rate in the alkalinization group compared to controls (RR 0.73, 95% CI: 0.56-0.95; I2 = 0%). However, our subgroup analysis showed no significant improvement in RCT-only studies (RR 0.78, 95% CI: 0.59-1.05; I2 = 0%), the recovery rate was significantly higher in the alkalinization group (RR 2.13, 95% CI: 1.39-3.26; I2 = 0%), duration of recovery also has improved in alkalinization group (SMD 0.76, 95% CI: 0.33-1.18; I2 = 0%). The results of our meta-analysis showed a significant reduction in the duration of hospitalization in the alkalinization group compared to controls with very low certainty of evidence (SMD -0.66, 95% CI: -0.97 to -0.35; I2 = 36%). Conclusion: With low certainty of evidence, alkalinization (by sodium bicarbonate) can be an efficient and safe adjuvant treatment for COVID-19 patients. Future randomized controlled trials are needed to strengthen the available evidence.
Conclusion Alkalinization using sodium bicarbonate in COVID-19 patients showed possible advantages through reducing the risk of mortality, and improving recovery rates. Although the results of the current study suggest the positive effect of alkalinization on COVID-19 outcomes, but higher-quality studies should concentrate on the investigation of alkalinization in COVID-19.
CRediT Author Statement
Declaration of Conflicting Interests The authors declare that they have no known competing interests.
Ethical Approval This study was approved by the ethics committee of Alborz University of Medical Sciences, Alborz, Karaj, Iran (IR.ABZUMS.REC.1402.154).
Informed Consent
Not applicable
Supplemental material Supplemental material for this article is available online.
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