A Randomized Controlled Trial to Investigate The Role of Adjuvant Inhalable Sodium Bicarbonate Solution 8.4% in Treatment of COVID-19

Corona virus disease 19 (COVID-19) is a rapidly spreading disease that involves almost every part of the world. Although numerous attempts are being carried out to prevent and treat the disease, there is no consensus about the gold standard treatment. In the recent study (El-Badrawy et al., 2021) our group published a controlled study investigating the role of inhalable sodium bicarbonate (SB) as adjuvant treatment of non-severe CT- identified COVID-19 pneumonia. The study concluded that sodium bicarbonate 8.4% inhalation with its nasal instillation could be a possible adjuvant therapy for patients with non-severe COVID-19 pneumonia. Nevertheless, our previous study suffers from some limitations being non randomized, with a small sample size and short duration of follow up. Moreover, the study included only moderate cases of COVID-19 and excluded mild and severe cases.

The present protocol is designed to avoid the limitations of our previous study in an attempt to obtain clear answer about the role of inhalable SB as an adjuvant treatment of COVID-19.

The emergence of new mutants of Corona virus is a new problem that can face the synthesized new anti COVID vaccines. The use of SB in treatment of COVID-19 may overcome Corona virus whatever its mutant variant.

We hypothize that SB may neutralize the effect of sialic acid through change of pH and change of the negative change, therefore prevent attachment, fusion and transport of the virus into the host cell.

Theory: