Efficacy of nasal irrigation and oral rinse with sodium bicarbonate solution on virus clearance for COVID-19 patients

Wang et al., Frontiers in Public Health, doi:10.3389/fpubh.2023.1145669, Mar 2023

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Alkalinization

30th treatment shown to reduce risk in November 2021, now with p = 0.0000000039 from 14 studies.

Lower risk for mortality, progression, recovery, and viral clearance.

No treatment is 100% effective. Protocols combine treatments.

5,700+ studies for 169 treatments. c19early.org

RCT 55 mild/moderate patients in China, showing shorter hospitalization with sodium bicarbonate nasal irrigation and oral rinsing. Oral rinse with 5% sodium bicarbonate solution three times daily. Nasal irrigation two times with the solution entering through one nostril and exiting from the other. 30–40mL of solution was used every time and irrigation was performed for at least 30s. Details of randomization are not provided.

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).

Standard of Care (SOC) for COVID-19 in the study country, China, is poor with low average efficacy for approved treatments1.

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hospitalization time, 38.5% lower, relative time 0.61, p < 0.001, treatment mean 7.7 (±4.15) n=23, control mean 12.53 (±5.56) n=32.

Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates

1. c19early.org, c19early.org/soc/china.html.c19early.org/soc/china.html.

Wang et al., 15 Mar 2023, Randomized Controlled Trial, China, peer-reviewed, 13 authors.

This Paper Alkalinization All

E cacy of nasal irrigation and oral rinse with sodium bicarbonate solution on virus clearance for COVID-patients

Ahmed Mostafa, Abdullah Salah Alanazi, Xu Wang, Wang T Zhang, Tairong Wang, Yue Zhang, Rong Zhang, Ye Mao, Junhai Yan, Yiwen Long, Qiaofeng Chen, Xiaojing Li, Huixiang Wang, Shuai Huang, Chao Zhu, Bin Teng

and Wang X ( ) E cacy of nasal irrigation and oral rinse with sodium bicarbonate solution on virus clearance for COVID-patients.

Ethics statement The studies involving human participants were reviewed and approved by Institutional Review Board of RuiJin Hospital LuWan Branch. The patients/participants provided their written informed consent to participate in this study. Author contributions TW, YZ, RZ, YM, JY, YL, QC, XL, HW, SH, CZ, and BT: methodology, investigation, and data curation. XW: writingoriginal draft, review and editing, conceptualization, supervision, and funding acquisition. All authors contributed to the article and approved the submitted version. Conflict of interest XW is employed by company Nanning Jiuzhouyuan Biotechnology Co Ltd. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Publisher's note All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

References

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Callaway, Heavily mutated Omicron variant puts scientists on alert, Nature, doi:10.1038/d41586-021-03552-w

Casale, Rinaldi, Sabatino, Moffa, Ciccozzi, Could nasal irrigation and oral rinse reduce the risk for COVID-19 infection?, Int J Immunopathol Pharmacol, doi:10.1177/2058738420941757

Chong, Head, Hopkins, Philpott, Schilder et al., Saline irrigation for chronic rhinosinusitis, Cochrane Database Syst Rev, doi:10.1002/14651858.CD011995.pub2

Circus, Viral Infections are pH Sensitive

Kassel, King, Spurling, Saline nasal irrigation for acute upper respiratory tract infections, Cochrane Database Syst Rev, doi:10.1002/14651858.CD006821.pub3

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Kumar, Kumar, Mahto, Singh, Gargling with 75% sodium bicarbonate solution for SARS-CoV-2 viremia clearance: our institutional clinical experience, Indian J Crit Care Med, doi:10.5005/jp-journals-10071-23901

Köksal, Cizmeci, Bozkaya, Kanburoglu, Sahin et al., Comparison between the use of saline and seawater for nasal obstruction in children under 2 years of age with acute upper respiratory infection, Turk J Med Sci, doi:10.3906/sag-1507-18

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DOI record: { "DOI": "10.3389/fpubh.2023.1145669", "ISSN": [ "2296-2565" ], "URL": "http://dx.doi.org/10.3389/fpubh.2023.1145669", "abstract": "BackgroundRecent studies have shown that the infectivity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is reduced under alkaline conditions. The purpose of this study is to assess the effect of nasal irrigation and oral rinse with sodium bicarbonate solution on virus clearance among COVID-19 patients.Materials and methodsCOVID-19 patients were recruited and randomly divided into two group, i.e., the experimental group and the control group. The experimental group received regular care plus nasal irrigation and oral rinse with 5% sodium bicarbonate solution, while the control group only received regular care. Nasopharyngeal and oropharyngeal swab samples were collected daily for reverse transcription-polymerase chain reaction (RT-PCR) assays. The negative conversion time and hospitalization time of the patients were recorded, and the results were statistically analyzed.ResultsA total of 55 COVID-19 patients with mild or moderate symptoms were included in our study. There was no significant difference in gender, age and health status between the two groups. The average negative conversion time was 1.63 days after treatment with sodium bicarbonate, and the average hospitalization time of the control group and the experimental group were 12.53 and 7.7 days, respectively.ConclusionsNasal irrigation and oral rinse with 5% sodium bicarbonate solution is effective in virus clearance for COVID-19 patients.", "alternative-id": [ "10.3389/fpubh.2023.1145669" ], "author": [ { "affiliation": [], "family": "Wang", "given": "Tairong", "sequence": "first" }, { "affiliation": [], "family": "Zhang", "given": "Yue", "sequence": "additional" }, { "affiliation": [], "family": "Zhang", "given": "Rong", "sequence": "additional" }, { "affiliation": [], "family": "Mao", "given": "Ye", "sequence": "additional" }, { "affiliation": [], "family": "Yan", "given": "Junhai", "sequence": "additional" }, { "affiliation": [], "family": "Long", "given": "Yiwen", "sequence": "additional" }, { "affiliation": [], "family": "Chen", "given": "Qiaofeng", "sequence": "additional" }, { "affiliation": [], "family": "Li", "given": "Xiaojing", "sequence": "additional" }, { "affiliation": [], "family": "Wang", "given": "Huixiang", "sequence": "additional" }, { "affiliation": [], "family": "Huang", "given": "Shuai", "sequence": "additional" }, { "affiliation": [], "family": "Zhu", "given": "Chao", "sequence": "additional" }, { "affiliation": [], "family": "Teng", "given": "Bin", "sequence": "additional" }, { "affiliation": [], "family": "Wang", "given": "Xu", "sequence": "additional" } ], "container-title": "Frontiers in Public Health", "container-title-short": "Front. 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Late treatment
is less effective

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