Hydrogen/oxygen mixed gas inhalation reduces the disease severity and dyspnea (breathing difficulty) in patients with Coronavirus disease

Vol 12, No 6 (June 2020): Journal of Thoracic Disease

Quick Look

  • Coronavirus disease 2019 (COVID-19) has resulted in more than 8.7 million laboratory-confirmed cases and 0.46 million deaths globally. 
  • Few therapies, if any, have been shown to rapidly ameliorate the respiratory symptoms and prevent the disease progression. 
  • An important mechanism contributing to dyspnea and disease progression in patients with COVID-19 might be the increased work of breathing because of the heightened airway resistance. 
  • Inhalation of hydrogen/oxygen mixed gas (H2-O2) might have a role in the treatment of COVID-19 given the decreased resistance compared with room air when passing through the airways.

  • An open-label multicenter clinical trial was conducted between January 21st and March 23rd, 2020, among patients with laboratory-confirmed COVID-19 from seven hospitals in China.
  • The patients were aged 18–85 years and had dyspnea both on hospital admission and at enrollment

  • H2-O2 inhalation resulted in significantly more patients with improved disease severity at day 2 (20.5% vs. 2.3%) and 3 (31.8% vs. 11.5%) and end-of-treatment (70.5% vs. 31.8%).
  • The improvement of the dyspnea scale (50.0% vs. 23.9%) was greater in the H2-O2 treatment group on day 2. H2-O2 inhalation improved chest distress and chest pain.
  • The improvement in the cough scale was greater in the treatment group at days 2 and 3.
  • Furthermore, the improvement in resting oxygen saturation was greater after H2-O2 inhalation.

  • On the basis of standard-of-care (3), patients in the treatment group inhaled H2-O2 (66% hydrogen; 33% oxygen) at 6 L/min via nasal cannula daily until discharge.
  • Patients in the control group received standard-of-care (with oxygen therapy each day) alone until discharge.
  • Clinical assessments included the five-category ordinal scale, the four-category ordinary scale of dyspnea, coughing, chest distress, and chest pain and adverse events, performed on admission, at enrollment, at days 2 and 3, and the day before discharge (end-of-treatment).
  • The primary endpoint was the proportion of patients with improved disease severity (by at least one scale). Secondary endpoints comprised the change from baseline in oxygen saturation and symptom scales.

Publication Available at the Journal of Thoracic Disease
Online Supplement http://dx.doi.org/10.21037/jtd-2020-057

Hydrogen/oxygen mixed gas inhalation improves disease severity and dyspnea in patients with Coronavirus disease 2019 in a recent multicenter, open-label clinical trial

Wei-Jie Guan1#, Chun-Hua Wei2,3#, Ai-Lan Chen4,5#, Xiao-Cong Sun6,7, Guang-Yun Guo8, Xu Zou9,10, Jin-Dong Shi10,11, Pei-Zhen Lai12, Ze-Guang Zheng1, Nan-Shan Zhong1

Correspondence to: Nan-Shan Zhong. State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang Road, Guangzhou, China. Email: nanshan@vip.163.com.

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