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

Background: Coronaviruses are classified as pH dependent. Alkaline media induced by sodium bicarbonate (SB) could impede viral entry into cells. We aimed to study the possible role of SB as an adjuvant treatment of nonsevere COVID-19 pneumonia. Methods: The study included 182 adults with confirmed nonsevere COVID-19 and chest computed tomography (CT) pneumonia; 127 assigned as study received conventional treatment plus adjuvant SB inhalation and nasal drops, as well as 55 assigned as control treated by conventional treatment only. Clinical and radiological assessments using chest CT score specific for COVID-19 were done at days 0 and 30. Results: Both the groups were comparable regarding demographic, clinical, and radiological characteristics. Clinical recovery was reported in 43/127 (33.9%) and 10/55 (18.2%) of the study and control groups, respectively (P = 0.03). The mean +/- standard deviation time to clinical improvement was 3.31 +/- 0.99 and 9.79 +/- 6.29 days for the study and control groups, respectively (P < 0.001). The median of the total chest CT score was reduced from 10 (4-15) to 3 (0-19) in the study group (P = 0.000) and from 13 (2-15) to 11 (2-19) in the control group (P = 0.53) on days 0 and 30, respectively. Conclusions: SB could be a possible adjuvant therapy for selected patients with nonsevere COVID-19 pneumonia.