Effects of nebulized hypertonic saline on inflammatory mediators in patients with severe COVID-19 pneumonia: A double-blinded randomized controlled trial

Effects of nebulized hypertonic saline on inflammatory mediators in patients with severe COVID-19 pneumonia: A double-blinded randomized controlled trial

Introduction: An exaggerated immune response is considered the most important aspect of COVID-19 pathogenesis. Hypertonic saline (HS) has shown promise in combating inflammation in several respiratory diseases. We investigated the effects of nebulized HS on clinical symptoms and inflammatory status...

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Published in:Science progress (1916) Vol. 106; no. 4; p. 368504231203130
Main Authors: Beigmohammadi, Mohammad-Taghi, Amoozadeh, Laya, Naghibi, Nikoosadat, Eslami, Babak, Fattah Ghazi, Samrand, Javaherian, Mohammad, Khajeh-Azad, Mohammad-Amin, Tabatabaei, Bahram, Abdollahi, Alireza, Nazar, Elham
Format: Journal Article
Language:English
Published: London, England SAGE Publications 01-10-2023
Sage Publications Ltd
Subjects:
Coronaviruses
COVID-19
Distilled water
Immune response
Inflammation
Interleukin 6
Intubation
Leukocytes
Mortality
Pathogenesis
Patients
Pneumonia
Respiratory diseases
Signs and symptoms
Statistical analysis
Tumor necrosis factor-TNF
Tumor necrosis factor-α
Viral diseases
Viral Pathogenesis and Virus-Host Interactions of Emerging Viruses
inflammatory mediators
COVID-19
Nebulized hypertonic saline
pneumonia
hospitalization
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Summary:Introduction: An exaggerated immune response is considered the most important aspect of COVID-19 pathogenesis. Hypertonic saline (HS) has shown promise in combating inflammation in several respiratory diseases. We investigated the effects of nebulized HS on clinical symptoms and inflammatory status in patients with severe novel coronavirus infection (COVID-19) pneumonia. Materials and Methods: We randomly assigned 60 adults admitted to the intensive care unit (ICU) due to severe COVID-19 pneumonia to the experimental (received nebulized 5% saline) and control (received nebulized distilled water) groups. All interventions were applied 4 times daily for 5 days. The levels of tumor necrosis factor-α (TNF-α), interleukin 6 (IL-6), and other clinical factors from venous blood were evaluated before and after intervention application. Mortality rate, intubation rate, and durations of ICU and hospital stay were also compared between groups. Results: The levels of TNF-α (MD: −21.35 [−32.29, −10.40], P  =  0.000) and IL-6 (−9.94 [−18.86, −1.02], P  =  0.003) were lower in the experimental group compared to the control group after applying the interventions. The levels of white blood cell count, PO2, and serum sodium were also statistically significant differences between groups. However, we did not observe significant differences in terms of hospitalization durations and mortality rates. Conclusion: Nebulization of HS in patients with severe COVID-19 pneumonia appears to be effective in reducing inflammation, but does not appear to affect intubation rates, mortality, hospitalization, or length of stay in ICU.
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ISSN:0036-8504
2047-7163
DOI:10.1177/00368504231203130