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All Studies   Meta Analysis    Recent:   
0 0.5 1 1.5 2+ Hospitalization time 39% Improvement Relative Risk Alkalinization  Wang et al.  LATE TREATMENT  RCT Is late treatment with alkalinization beneficial for COVID-19? RCT 55 patients in China Shorter hospitalization with alkalinization (p=0.0009) c19early.org Wang et al., Frontiers in Public Health, Mar 2023 Favors alkalinization Favors control

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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31st treatment shown to reduce risk in December 2021
 
*, now known with p = 0.0000043 from 11 studies.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
3,900+ studies for 60+ 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).
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
Wang et al., 15 Mar 2023, Randomized Controlled Trial, China, peer-reviewed, 13 authors.
This PaperAlkalinizationAll
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
Cabaillot, Vorilhon, Roca, Boussageon, Eschalier et al., Saline nasal irrigation for acute upper respiratory tract infections in infants and children: A systematic review and meta-analysis, Paediat Resp Rev, doi:10.1016/j.prrv.2019.11.003
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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
Kim, Use of mouthwash in preventing transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Int J Sci, doi:10.18483/ijSci.2568
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
Lowe, Xie, Chen, Shen, Sun, It's not the time to relax yet: masks are still needed for the Omicron variant of SARS-CoV-2, Public Health, doi:10.1016/j.puhe.2022.01.030
Mawaddah, Genden, Lum, Marina, Upper respiratory tract sampling in COVID-19, Malaysian J Pathol
Sturman, Ricard, Holmes, Conformational change of the coronavirus peplomer glycoprotein at pH 80 and 37 degrees C correlates with virus aggregation and virus-induced cell fusion, J Virol
Xu, Piper-Vallillo, Bindal, Wischhusen, Patel et al., Patterns of viral clearance in the natural course of asymptomatic coronavirus disease 2019 (COVID-19): comparison with symptomatic nonsevere COVID-19, doi:10.1016/j.ijid.2020.07.070
Yang, Liu, Zhang, Liu, Clinical observation on nasal irrigation treatment in patients with allergic rhinitis, Ningxia Med J, doi:10.13621/j.1001-5949.2015.02.0148
Yang, Shen, Targeting the endocytic pathway and autophagy process as a novel therapeutic strategy in COVID-19, Int J Biol Sci, doi:10.7150/ijbs.45498
Zou, Ruan, Huang, Liang, Huang et al., SARS-CoV-2 viral load in upper respiratory specimens of infected patients|NEJM, N Engl J Med, doi:10.1056/NEJMc2001737
Šlapak, Skoupá, Strnad, Horník, Efficacy of isotonic nasal wash (seawater) in the treatment and prevention of rhinitis in children, Arch Otolaryngol Head Neck Surg, doi:10.1001/archoto.2007.19
Late treatment
is less effective
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