Inhalational Ethanol Therapy in COVID-19 Treatment and Prevention

Ali Amoushahi; Elham Moazam; Pietro Salvatori

doi:doi:10.11648/j.ass.20231102.11

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Inhalational Ethanol Therapy in COVID-19 Treatment and Prevention

Ali Amoushahi, Elham Moazam, Pietro Salvatori

Published in Advances in Surgical Sciences (Volume 11, Issue 2)

Received: 16 March 2023 Accepted: 21 April 2023 Published: 13 July 2023

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Abstract

Background: Considering the proven anti coronavirus (SARS-CoV-2) and immunomodulatory effects of the ethanol, the efficacy of its administration was evaluated in this research. Because of respiratory tract entrance of virus and pulmonary involvement in COVID-19, this study was done by inhalation of nebulized ethanol. Methods: Ninety-nine symptomatic and positive SARS-CoV-2-PCR patients who had been admitted at a respiratory clinic to receive Remdesivir-Dexamethasone were included in this triple-blind trial study. Patients were randomly assigned to the control (placebo, distilled water spray) and intervention (35% ethanol spray) group. Both groups were instructed to inhale 3 puffs of spray (nebulizer) and breathe through the nose and mouth via a face mask, every six hours for a week. Global symptomatic score (GSS), clinical status scale (CSS) based on a 7-point ordinal scale ranging from death (category 1) to complete recovery (category 7), percentage of blood oxygen (with pulse oximeter), and C-Reactive Protein (CRP) level at the first visit and days 3, 7, 14 were measured and compared between the two groups. Results: GSS at the beginning of the study in the intervention group was similar to the control group (6.72±2.07 vs 6.67±2.09 respectively, P=0.91). Based on the analysis of repeated measures, the GSS decreased more and faster in the intervention group (ethanol) (1.4±1.4 vs 2.3±1.7, P=0.035) two weeks after starting intervention. On day 14, the odds of intervention group to have better clinical status was 5.715 times (95% CI, 2.47 to 13.19) than of control group a statistically significant effect, Wald χ2 (1) =16.67, P =0.001. Blood oxygen saturation also improved earlier in the ethanol group than in the control group, although the difference did not reach its statistical significance level (95.95%±2 vs 94.46%±1.8, P=0.097). The readmission rate after the complete period of treatment was lower in the intervention group (zero vs 10.9%, P=0.02). There was no need for intensive care unit hospitalization in both groups. The mortality rate was zero in both groups. Conclusion: Looking at the efficacy of the inhaled nebulized ethanol, its use seems to be effective in general rapid improvement, mitigating clinical symptoms and reducing the need to repeat treatment. Considering the low cost, availability and no significant adverse events of ethanol, research and additional efforts are recommended to evaluate its curative and preventive effects in the early stages of COVID-19.

Published in	Advances in Surgical Sciences (Volume 11, Issue 2)
DOI	10.11648/j.ass.20231102.11
Page(s)	22-28
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2023. Published by Science Publishing Group

Keywords

COVID-19, Ethanol, Inhalation, Nebulizer

References

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[4]	Mors K, Horauf J-A, Kany S, Wagner N, Sturm R, Woschek M, et al. Ethanol decreases inflammatory response in human lung epithelial cells by inhibiting the canonical NF-kB-pathway. Cellular Physiology and Biochemistry. 2017; 43 (1): 17-30.
[5]	Chandrasekar A, olde Heuvel F, Palmer A, Linkus B, Ludolph AC, Boeckers TM, et al. Acute ethanol administration results in a protective cytokine and neuroinflammatory profile in traumatic brain injury. International immunopharmacology. 2017; 51: 66-75.
[6]	Boe DM, Nelson S, Zhang P, Bagby GJ. Acute ethanol intoxication suppresses lung chemokine production following infection with Streptococcus pneumoniae. The Journal of infectious diseases. 2001; 184 (9): 1134-42.
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[9]	Acevedo SF, Gonzalez DA, Rodan AR, Rothenfluh A. S6 Kinase reflects and regulates ethanol-induced sedation. Journal of Neuroscience. 2015; 35 (46): 15396-402.
[10]	Arout CA, Perrino Jr AC, Ralevski E, Acampora G, Koretski J, Limoncelli D, et al. Effect of intravenous ethanol on capsaicin-induced hyperalgesia in human subjects. Alcoholism: Clinical and Experimental Research. 2016; 40 (7): 1425-9.
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[13]	Haas DM, Morgan AM, Deans SJ, Schubert FP. Ethanol for preventing preterm birth in threatened preterm labor. Cochrane Database of Systematic Reviews. 2015 (11).
[14]	Teran E, Racines-Orbe M, Vivero S, Escudero C, Molina G, Calle A. Preeclampsia is associated with a decrease in plasma coenzyme Q10 levels. Free Radical Biology and Medicine. 2003; 35 (11): 1453-6.
[15]	Gootnick A, Lipson HI, Turbin J. Inhalation of ethyl alcohol for pulmonary edema. New England Journal of Medicine. 1951; 245 (22): 842-3.
[16]	Ana Castro-Balado and all, Development and Characterization of Inhaled Ethanol as a Novel Pharmacological Strategy Currently Evaluated in a Phase II Clinical Trial for Early-Stage SARS-CoV-2 Infection, Pharmaceutics. 2021. Mar 5; 13 (3): 342. doi: 10.3390/pharmaceutics13030342.
[17]	Ezz A, Amoushahi A, Rashad A. Disinfection of SARS-COV-2 (COVID-19) in Human Respiratory Tract by Controlled Ethanol Vapor Inhalation combined with Asprin. J Vaccines Vaccin. 2021; 12: 454.
[18]	Salvatori P. The rationale of ethanol inhalation for disinfection of the respiratory tract in SARS-CoV-2-positive asymptomatic subjects. Pan African Medical Journal. 2021; 40: 201. [doi: 10.11604/pamj.2021.40.201.31211].
[19]	Spinner C, Gottlieb R, Criner G. Arribas Ló pez JR, Cattelan AM, Soriano Viladomiu A, et al. Effect of Remdesivir vs Standard Care on Clinical Status at 11 Days in Patients with Moderate COVID-19: A Randomized Clinical Trial. JAMA—J Am Med Assoc. 2020; 324 (11): 1048-57.

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Ali Amoushahi, Elham Moazam, Pietro Salvatori. (2023). Inhalational Ethanol Therapy in COVID-19 Treatment and Prevention. Advances in Surgical Sciences, 11(2), 22-28. https://doi.org/10.11648/j.ass.20231102.11

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ACS Style

Ali Amoushahi; Elham Moazam; Pietro Salvatori. Inhalational Ethanol Therapy in COVID-19 Treatment and Prevention. Adv. Surg. Sci. 2023, 11(2), 22-28. doi: 10.11648/j.ass.20231102.11

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AMA Style

Ali Amoushahi, Elham Moazam, Pietro Salvatori. Inhalational Ethanol Therapy in COVID-19 Treatment and Prevention. Adv Surg Sci. 2023;11(2):22-28. doi: 10.11648/j.ass.20231102.11

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@article{10.11648/j.ass.20231102.11,
  author = {Ali Amoushahi and Elham Moazam and Pietro Salvatori},
  title = {Inhalational Ethanol Therapy in COVID-19 Treatment and Prevention},
  journal = {Advances in Surgical Sciences},
  volume = {11},
  number = {2},
  pages = {22-28},
  doi = {10.11648/j.ass.20231102.11},
  url = {https://doi.org/10.11648/j.ass.20231102.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ass.20231102.11},
  abstract = {Background: Considering the proven anti coronavirus (SARS-CoV-2) and immunomodulatory effects of the ethanol, the efficacy of its administration was evaluated in this research. Because of respiratory tract entrance of virus and pulmonary involvement in COVID-19, this study was done by inhalation of nebulized ethanol. Methods: Ninety-nine symptomatic and positive SARS-CoV-2-PCR patients who had been admitted at a respiratory clinic to receive Remdesivir-Dexamethasone were included in this triple-blind trial study. Patients were randomly assigned to the control (placebo, distilled water spray) and intervention (35% ethanol spray) group. Both groups were instructed to inhale 3 puffs of spray (nebulizer) and breathe through the nose and mouth via a face mask, every six hours for a week. Global symptomatic score (GSS), clinical status scale (CSS) based on a 7-point ordinal scale ranging from death (category 1) to complete recovery (category 7), percentage of blood oxygen (with pulse oximeter), and C-Reactive Protein (CRP) level at the first visit and days 3, 7, 14 were measured and compared between the two groups. Results: GSS at the beginning of the study in the intervention group was similar to the control group (6.72±2.07 vs 6.67±2.09 respectively, P=0.91). Based on the analysis of repeated measures, the GSS decreased more and faster in the intervention group (ethanol) (1.4±1.4 vs 2.3±1.7, P=0.035) two weeks after starting intervention. On day 14, the odds of intervention group to have better clinical status was 5.715 times (95% CI, 2.47 to 13.19) than of control group a statistically significant effect, Wald χ2 (1) =16.67, P =0.001. Blood oxygen saturation also improved earlier in the ethanol group than in the control group, although the difference did not reach its statistical significance level (95.95%±2 vs 94.46%±1.8, P=0.097). The readmission rate after the complete period of treatment was lower in the intervention group (zero vs 10.9%, P=0.02). There was no need for intensive care unit hospitalization in both groups. The mortality rate was zero in both groups. Conclusion: Looking at the efficacy of the inhaled nebulized ethanol, its use seems to be effective in general rapid improvement, mitigating clinical symptoms and reducing the need to repeat treatment. Considering the low cost, availability and no significant adverse events of ethanol, research and additional efforts are recommended to evaluate its curative and preventive effects in the early stages of COVID-19.},
 year = {2023}
}

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TY  - JOUR
T1  - Inhalational Ethanol Therapy in COVID-19 Treatment and Prevention
AU  - Ali Amoushahi
AU  - Elham Moazam
AU  - Pietro Salvatori
Y1  - 2023/07/13
PY  - 2023
N1  - https://doi.org/10.11648/j.ass.20231102.11
DO  - 10.11648/j.ass.20231102.11
T2  - Advances in Surgical Sciences
JF  - Advances in Surgical Sciences
JO  - Advances in Surgical Sciences
SP  - 22
EP  - 28
PB  - Science Publishing Group
SN  - 2376-6182
UR  - https://doi.org/10.11648/j.ass.20231102.11
AB  - Background: Considering the proven anti coronavirus (SARS-CoV-2) and immunomodulatory effects of the ethanol, the efficacy of its administration was evaluated in this research. Because of respiratory tract entrance of virus and pulmonary involvement in COVID-19, this study was done by inhalation of nebulized ethanol. Methods: Ninety-nine symptomatic and positive SARS-CoV-2-PCR patients who had been admitted at a respiratory clinic to receive Remdesivir-Dexamethasone were included in this triple-blind trial study. Patients were randomly assigned to the control (placebo, distilled water spray) and intervention (35% ethanol spray) group. Both groups were instructed to inhale 3 puffs of spray (nebulizer) and breathe through the nose and mouth via a face mask, every six hours for a week. Global symptomatic score (GSS), clinical status scale (CSS) based on a 7-point ordinal scale ranging from death (category 1) to complete recovery (category 7), percentage of blood oxygen (with pulse oximeter), and C-Reactive Protein (CRP) level at the first visit and days 3, 7, 14 were measured and compared between the two groups. Results: GSS at the beginning of the study in the intervention group was similar to the control group (6.72±2.07 vs 6.67±2.09 respectively, P=0.91). Based on the analysis of repeated measures, the GSS decreased more and faster in the intervention group (ethanol) (1.4±1.4 vs 2.3±1.7, P=0.035) two weeks after starting intervention. On day 14, the odds of intervention group to have better clinical status was 5.715 times (95% CI, 2.47 to 13.19) than of control group a statistically significant effect, Wald χ2 (1) =16.67, P =0.001. Blood oxygen saturation also improved earlier in the ethanol group than in the control group, although the difference did not reach its statistical significance level (95.95%±2 vs 94.46%±1.8, P=0.097). The readmission rate after the complete period of treatment was lower in the intervention group (zero vs 10.9%, P=0.02). There was no need for intensive care unit hospitalization in both groups. The mortality rate was zero in both groups. Conclusion: Looking at the efficacy of the inhaled nebulized ethanol, its use seems to be effective in general rapid improvement, mitigating clinical symptoms and reducing the need to repeat treatment. Considering the low cost, availability and no significant adverse events of ethanol, research and additional efforts are recommended to evaluate its curative and preventive effects in the early stages of COVID-19.
VL  - 11
IS  - 2
ER  -

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Author Information

Ali Amoushahi

Department of Anesthesiology and Intensive Care, Isfahan University of Medical Sciences, Isfahan, Iran
Elham Moazam

Department of Cancer Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
Pietro Salvatori

Department of Ear, Nose and Throat, Humanitas San Pio X Hospital, Milan, Italy

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APA Style

Ali Amoushahi, Elham Moazam, Pietro Salvatori. (2023). Inhalational Ethanol Therapy in COVID-19 Treatment and Prevention. Advances in Surgical Sciences, 11(2), 22-28. https://doi.org/10.11648/j.ass.20231102.11

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ACS Style

Ali Amoushahi; Elham Moazam; Pietro Salvatori. Inhalational Ethanol Therapy in COVID-19 Treatment and Prevention. Adv. Surg. Sci. 2023, 11(2), 22-28. doi: 10.11648/j.ass.20231102.11

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AMA Style

Ali Amoushahi, Elham Moazam, Pietro Salvatori. Inhalational Ethanol Therapy in COVID-19 Treatment and Prevention. Adv Surg Sci. 2023;11(2):22-28. doi: 10.11648/j.ass.20231102.11

Copy | Download

@article{10.11648/j.ass.20231102.11,
  author = {Ali Amoushahi and Elham Moazam and Pietro Salvatori},
  title = {Inhalational Ethanol Therapy in COVID-19 Treatment and Prevention},
  journal = {Advances in Surgical Sciences},
  volume = {11},
  number = {2},
  pages = {22-28},
  doi = {10.11648/j.ass.20231102.11},
  url = {https://doi.org/10.11648/j.ass.20231102.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ass.20231102.11},
  abstract = {Background: Considering the proven anti coronavirus (SARS-CoV-2) and immunomodulatory effects of the ethanol, the efficacy of its administration was evaluated in this research. Because of respiratory tract entrance of virus and pulmonary involvement in COVID-19, this study was done by inhalation of nebulized ethanol. Methods: Ninety-nine symptomatic and positive SARS-CoV-2-PCR patients who had been admitted at a respiratory clinic to receive Remdesivir-Dexamethasone were included in this triple-blind trial study. Patients were randomly assigned to the control (placebo, distilled water spray) and intervention (35% ethanol spray) group. Both groups were instructed to inhale 3 puffs of spray (nebulizer) and breathe through the nose and mouth via a face mask, every six hours for a week. Global symptomatic score (GSS), clinical status scale (CSS) based on a 7-point ordinal scale ranging from death (category 1) to complete recovery (category 7), percentage of blood oxygen (with pulse oximeter), and C-Reactive Protein (CRP) level at the first visit and days 3, 7, 14 were measured and compared between the two groups. Results: GSS at the beginning of the study in the intervention group was similar to the control group (6.72±2.07 vs 6.67±2.09 respectively, P=0.91). Based on the analysis of repeated measures, the GSS decreased more and faster in the intervention group (ethanol) (1.4±1.4 vs 2.3±1.7, P=0.035) two weeks after starting intervention. On day 14, the odds of intervention group to have better clinical status was 5.715 times (95% CI, 2.47 to 13.19) than of control group a statistically significant effect, Wald χ2 (1) =16.67, P =0.001. Blood oxygen saturation also improved earlier in the ethanol group than in the control group, although the difference did not reach its statistical significance level (95.95%±2 vs 94.46%±1.8, P=0.097). The readmission rate after the complete period of treatment was lower in the intervention group (zero vs 10.9%, P=0.02). There was no need for intensive care unit hospitalization in both groups. The mortality rate was zero in both groups. Conclusion: Looking at the efficacy of the inhaled nebulized ethanol, its use seems to be effective in general rapid improvement, mitigating clinical symptoms and reducing the need to repeat treatment. Considering the low cost, availability and no significant adverse events of ethanol, research and additional efforts are recommended to evaluate its curative and preventive effects in the early stages of COVID-19.},
 year = {2023}
}

Copy | Download

TY  - JOUR
T1  - Inhalational Ethanol Therapy in COVID-19 Treatment and Prevention
AU  - Ali Amoushahi
AU  - Elham Moazam
AU  - Pietro Salvatori
Y1  - 2023/07/13
PY  - 2023
N1  - https://doi.org/10.11648/j.ass.20231102.11
DO  - 10.11648/j.ass.20231102.11
T2  - Advances in Surgical Sciences
JF  - Advances in Surgical Sciences
JO  - Advances in Surgical Sciences
SP  - 22
EP  - 28
PB  - Science Publishing Group
SN  - 2376-6182
UR  - https://doi.org/10.11648/j.ass.20231102.11
AB  - Background: Considering the proven anti coronavirus (SARS-CoV-2) and immunomodulatory effects of the ethanol, the efficacy of its administration was evaluated in this research. Because of respiratory tract entrance of virus and pulmonary involvement in COVID-19, this study was done by inhalation of nebulized ethanol. Methods: Ninety-nine symptomatic and positive SARS-CoV-2-PCR patients who had been admitted at a respiratory clinic to receive Remdesivir-Dexamethasone were included in this triple-blind trial study. Patients were randomly assigned to the control (placebo, distilled water spray) and intervention (35% ethanol spray) group. Both groups were instructed to inhale 3 puffs of spray (nebulizer) and breathe through the nose and mouth via a face mask, every six hours for a week. Global symptomatic score (GSS), clinical status scale (CSS) based on a 7-point ordinal scale ranging from death (category 1) to complete recovery (category 7), percentage of blood oxygen (with pulse oximeter), and C-Reactive Protein (CRP) level at the first visit and days 3, 7, 14 were measured and compared between the two groups. Results: GSS at the beginning of the study in the intervention group was similar to the control group (6.72±2.07 vs 6.67±2.09 respectively, P=0.91). Based on the analysis of repeated measures, the GSS decreased more and faster in the intervention group (ethanol) (1.4±1.4 vs 2.3±1.7, P=0.035) two weeks after starting intervention. On day 14, the odds of intervention group to have better clinical status was 5.715 times (95% CI, 2.47 to 13.19) than of control group a statistically significant effect, Wald χ2 (1) =16.67, P =0.001. Blood oxygen saturation also improved earlier in the ethanol group than in the control group, although the difference did not reach its statistical significance level (95.95%±2 vs 94.46%±1.8, P=0.097). The readmission rate after the complete period of treatment was lower in the intervention group (zero vs 10.9%, P=0.02). There was no need for intensive care unit hospitalization in both groups. The mortality rate was zero in both groups. Conclusion: Looking at the efficacy of the inhaled nebulized ethanol, its use seems to be effective in general rapid improvement, mitigating clinical symptoms and reducing the need to repeat treatment. Considering the low cost, availability and no significant adverse events of ethanol, research and additional efforts are recommended to evaluate its curative and preventive effects in the early stages of COVID-19.
VL  - 11
IS  - 2
ER  -

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