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Review
. 2022 Jun 21:9:917008.
doi: 10.3389/fmed.2022.917008. eCollection 2022.

Hypertonic Solution in Severe COVID-19 Patient: A Potential Adjuvant Therapy

Matheus Gennari-Felipe  1 , Leandro Borges  1 , Alexandre Dermargos  1 , Eleine Weimann  1 , Rui Curi  1   2 , Tania Cristina Pithon-Curi  1 , Elaine Hatanaka  1
Affiliations
Review

Hypertonic Solution in Severe COVID-19 Patient: A Potential Adjuvant Therapy

Matheus Gennari-Felipe et al. Front Med (Lausanne). .

Abstract

Coronavirus disease 2019 (COVID-19) features hyper-inflammation, cytokine storm, neutrophil function changes, and sodium chloride (NaCl) homeostasis disruption, while the treatment with NaCl hypertonic solutions (HS) controls electrolytic body homeostasis and cell functions. HS treatment is a simple, popular, economic, and feasible therapy to regulate leukocyte function with a robust anti-inflammatory effect in many inflammatory diseases. The purpose of this narrative review is to highlight the knowledge on the use of HS approaches against viral infection over the past years and to describe the mechanisms involved in the release of neutrophil extracellular traps (NETs) and production of cytokine in severe lung diseases, such as COVID-19. We reported the consequences of hyponatremia in COVID-19 patients, and the immunomodulatory effects of HS, either in vitro or in vivo. We also described the relationship between electrolyte disturbances and COVID-19 infection. Although there is still a lack of clinical trials, hypertonic NaCl solutions have marked effects on neutrophil function and NETs formation, emerging as a promising adjuvant therapy in COVID-19.

Keywords: NETosis; NETs; NaCl; coronavirus; immune system; leukocytes; neutrophils.

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Conflict of interest statement

The 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.

Figures

FIGURE 1
FIGURE 1
The possible beneficial effects of hypertonic saline solution decreasing neutrophils’ hyperresponsiveness in the coronavirus disease.
See this image and copyright information in PMC

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