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Effects of Sodium Pyruvate Nasal Spray in COVID-19 Long Haulers.

Preliminary Examination of the Effects of Sodium Pyruvate Nasal Spray (N115) on Symptoms Associated With COVID19 Long Haulers.

Status
Completed
Phases
Phase 2Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT04871815
Enrollment
22
Registered
2021-05-04
Start date
2021-04-27
Completion date
2022-03-07
Last updated
2022-03-09

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Long COVID

Keywords

COVID19, Long Haulers

Brief summary

There are approximately 12 million Americans with COVID-19 Long Hauler Symptoms, including athletes. The symptoms include hypoxemia (low SaO2), fatigue, coughing/sneezing, dyspnea, trouble breathing, body aches, headaches. This chronic disease is referred to as COVID-19 Long Haulers. 7-10% of COVID-19 long haulers are also at serious risk of developing Pulmonary Fibrosis. Conversely, patients with Pulmonary Fibrosis have an increased risk and susceptibility to COVID-19 infection, which can reach a mortality rate of 50%. In a Phase III Clinical Trial in patients in Pulmonary Fibrosis and Idiopathic pulmonary fibrosis, the inhalation of the sodium pyruvate nasal spray demonstrated a statistically and clinically significant improvement in all lung functions, compared to baseline, including an increase in FEV-1, SaO2, FVC, FEV-1/FVC ratios (from 52% to 86%) and a reduction in coughing and fatigue. EmphyCorp/Cellular Sciences Inc. has submitted over 17 human clinicals (Phase I, II, III including animal safety data) to the FDA, demonstrating that the inhalation of sodium pyruvate, significantly reduced respiratory and nasal Inflammation, including oxygen radicals and inflammatory cytokines including IL-6, that causes the so-called cytokine storm COVID-19 patients. Thousands of patients treated with inhaled sodium pyruvate including patients with COPD, Pulmonary Fibrosis, CF, Allergic Rhinitis, Chronic Rhinitis, Sinusitis, and Flu, demonstrated statistically and clinically significant improvement in lung functions with no adverse events reported. This study will examine the effects of N115 (Sodium pyruvate nasal spray) treatment on the symptoms associated with COVID-19 Long Haulers.

Detailed description

In numerous human clinical trials (17, phase I, II, III clinical trials) submitted to the FDA, for COPD, Pulmonary Fibrosis, CF, Allergic Rhinitis, Chronic Rhinitis, Sinusitis, and Flu patients, inhaled sodium pyruvate reduced nasal and lung inflammation and congestion by reducing inflammatory cytokines including the IL-6 cytokine that causes the so-called cytokine storm with no known adverse reactions. Cellular Sciences received Orphan Drug Designations for Pulmonary Fibrosis and Cystic Fibrosis. Mice studies conducted by Dr. Lupfer at Missouri State University substantiated our finding by testing nebulized sodium pyruvate in flu (influenza A H1N1 virus) infected mice that decreased morbidity, weight loss, proinflammatory cytokines, and decreased viral titers (virus numbers) compared to the Saline Placebo Control. Additionally, treated mice consumed more chow during infection indicating improved symptoms (same results reported in a pilot mice COVID-19 study). There were notable improvements in pro-inflammatory cytokine production (IL-1β) and lower virus titers (viral numbers) on days 7 post infection in mice treated with Sodium pyruvate compared to the Saline Placebo Control animals. As pyruvate acts on the host immune response, metabolic pathways and not directly on the virus, our data demonstrate that sodium pyruvate is a promising treatment option that is safe, effective, and unlikely to elicit antiviral resistance. Furthermore, we have preliminary data that suggest it may work similarly during other respiratory virus infections including COVID19/SARS-CoV-2. In a Phase III Placebo Controlled Clinical Trial with Idiopathic Pulmonary Fibrosis Patients, inhaled sodium pyruvate, a Non-Steroidal Nasal Spray (N115) demonstrated a statistically and clinically significant increase in FEV-1, SaO2, FVC, FEV-1/FVC ratios (from 52% to 86%), and a statistically and clinically significant reduction in coughing, hypoxemia and a reduction in nasal and lung inflammation. Inhaled sodium pyruvate alleviated the symptoms associated with the COVID-19 infections in Patients with COPD and Pulmonary Fibrosis. Nasal Nitric Oxide reduces the rate, duration and severity of viral infections in healthy young children and in healthy adults from the Flu, Rhinovirus and Coronavirus. The literature has reported that Nitric Oxide is elicited and inhibits viral replication in pigs infected with porcine respiratory coronavirus. Additionally Nasal Nitric Oxide levels decreases from normal levels found in healthy adults, in patients with asthma (87%), COPD (73%) CF (44%) and Primary Ciliary Dyskinesia (7%). The rate of infections increases with decreasing levels of nasal nitric oxide. Young children, 6-17 years of age, produce (142%) more nitric oxide than healthy adults, which may explain their resistance to COVID-19. Recently, researchers announced that a high percentage of COVID-19 infected patients that were hospitalized were Diabetics or were Pre-Diabetic. The literature has reported that elevated levels of glucose in patients with diabetes mellitus cause a deficiency in the production of nitric oxide by blunting nitric oxide synthesis, which may explain their susceptibility to COVID-19. Sodium pyruvate increases nitric oxide and is safe for use by Patients with Diabetes. The inhalation of nasal sodium pyruvate increased the synthesis of nasal nitric oxide to normal levels in patients with low levels of nitric oxide to increase all lung functions and decrease the rate of infections. A clinical survey of 367 patients who took a nasal spray similar to EmphyCorp' s N115 formula, over a two-year period demonstrated a statistically significant decrease in the number, symptoms, and severity of seasonal flu respiratory tract infections. The number of flu or colds was reduced by 70% in Children and approximately 52% in Pregnant Women, Patients with Allergic Rhinitis, Diabetes, and Pulmonary Fibrosis. It has been used successfully by over 3.5 million patients globally in over 200 hospitals during the past 8 years to treat nasal and lung inflammation, congestion in Patients with COPD, Allergic Rhinitis, Pulmonary Fibrosis, sinusitis, the flu and Cystic Fibrosis, with no adverse events reported. It has been used by Children, Diabetics, and Hypertensives, with efficacy and with no known side effects. It has even been shown to be safe for use by Pregnant Women, for whom steroids are contraindicated as they increase the risk of low birth-weight babies. There are approximately 12 million Americans with COVID-19 Long Hauler Symptoms, including athletes. The symptoms include hypoxemia (low SaO2), fatigue, coughing/sneezing, dyspnea, trouble breathing, body aches, headaches. This chronic disease is referred to as COVID-19 Long Haulers. 7-10% of COVID-19 long haulers are also at serious risk of developing Pulmonary Fibrosis. Conversely, patients with Pulmonary Fibrosis have an increased risk and susceptibility to COVID-19 infection, which can reach a mortality rate of 50%. In a Phase III Clinical Trial in patients in Pulmonary Fibrosis and Idiopathic pulmonary fibrosis, the inhalation of the sodium pyruvate nasal spray demonstrated a statistically and clinically significant improvement in all lung functions, compared to baseline, including an increase in FEV-1, SaO2, FVC, FEV-1/FVC ratios (from 52% to 86%) and a reduction in coughing and fatigue. EmphyCorp/Cellular Sciences Inc. has submitted over 17 human clinicals (Phase I, II, III including animal safety data) to the FDA, demonstrating that the inhalation of sodium pyruvate, significantly reduced respiratory and nasal Inflammation, including oxygen radicals and inflammatory cytokines including IL-6, that causes the so-called cytokine storm COVID-19 patients. Thousands of patients treated with inhaled sodium pyruvate including patients with COPD, Pulmonary Fibrosis, CF, Allergic Rhinitis, Chronic Rhinitis, Sinusitis, and Flu, demonstrated statistically and clinically significant improvement in lung functions with no adverse events reported. This study will examine the effects of N115 (Sodium pyruvate nasal spray) treatment on the symptoms associated with COVID-19 Long Haulers.

Interventions

DRUGsodium pyruvate nasal spray

Subjects will use a sodium pyruvate nasal spray 3x daily for 7 days.

Sponsors

Missouri State University
CollaboratorOTHER
Dynamic DNA Laboratories
CollaboratorINDUSTRY
Trinity Health System
CollaboratorINDUSTRY
Family First Medical Research Center
CollaboratorOTHER
Cellular Sciences, inc.
Lead SponsorINDUSTRY

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Intervention model description

All subjects will be monitored for 1 week without intervention to obtain a baseline for signs and symptoms associated with COVID19 Long Haulers. All subjects will then be monitored for an additional week for signs and symptoms of COVID19 Long Haulers while using the N115 sodium pyruvate nasal spray 3x daily for that week.

Eligibility

Sex/Gender
ALL
Age
18 Years to 40 Years
Healthy volunteers
No

Inclusion criteria

* A prior confirmed positive test for COVID19 and lingering symptoms are required for inclusion. As outlined on the CDC website, lingering symptoms include: * Tiredness or fatigue * Difficulty thinking or concentrating (sometimes referred to as brain fog) * Headache * Loss of smell or taste * Dizziness on standing * Fast-beating or pounding heart (also known as heart palpitations) * Chest pain * Difficulty breathing or shortness of breath * Cough * Joint or muscle pain * Depression or anxiety * Fever * Symptoms that get worse after physical or mental activities

Exclusion criteria

* Viral infections other than COVID-19. * Clinically significant cardiac disease including uncontrolled congestive heart failure and unstable angina * Pregnancy * Females of childbearing potential age not on adequate contraception or lactating * Subjects receiving systemic corticosteroid treatment within one month of Screening Visit * Subjects Less than 18 years of age * Hospitalization within last 6 months due to acute exacerbation of airway disease * Subjects with a clinically significant abnormal chest x-ray within past 12 months * Medication changes within one month of study entry * Subjects who have participated in another investigation drug treatment study within the previous month. * Subjects with a current history of alcohol or recreational drug abuse. * Subjects who have taken dietary supplements containing pyruvate within 24 hours prior to the screening visit.

Design outcomes

Primary

MeasureTime frameDescription
Change in Blood Oxygenation in Long COVID-19 PatientsDay 1 (1st day Baseline), Day 8 (8th day Baseline), Day 8 (1st day Post-treatment) and Day 14 (7th day post-treatment)Blood oxygenation will be measured as %O2 saturation.
Change in the Symptoms of Long COVID-19 Patients14 daysA patient log was used to measure body ache, headache, chills, coughing/sneezing, sore throat, congestion, trouble breathing and other (patient supplied). The patients used a Likert scale from 0 to 10 to assess symptoms with 10 representing the most severe symptom and zero no symptom. The score for each individual symptom was combined into one overall symptom score for the 7 days of baseline (days 1-7) and a separate score for the 7 days of treatment (days 8-14). Therefore, a maximum 7-day score was 70 and a minimum of 0 was possible.
Change in Body Temperature in Long COVID-19 Patients14 daysBody temperature will be measured twice daily by thermometer in degrees Fahrenheit. Average body temperature for the first 7 days (days 1-7) was used as a baseline with no treatment and was compared to the average body temperature for the next 7 days (days 8-14) with 20mM sodium pyruvate treatment.
Change in Pulse Rate in Long COVID-19 PatientsDay 1 (1st day Baseline), Day 8 (8th day Baseline), Day 8 (1st day Post-treatment) and Day 14 (7th day post-treatment)Patient heart rate will be measured as beats per minute.

Countries

United States

Participant flow

Pre-assignment details

22 patients were enrolled and served as their own baseline control for 7 days followed by 7 days of treatment.

Participants by arm

ArmCount
Treatment of COVID19 Long Haulers With Sodium Pyruvate Nasal Spray
This is a single arm, two phased, open label study. All subjects will be provided a log for monitoring baseline symptoms associated with Long COVID and asked to record symptom severity using a Likert scale for one week with no treatment. Vital signs (Blood pressure, temperature, Pulse and SaO2) will be recorded on day 1 and 7. After recording baseline symptoms for one week without any treatment, all subjects will then use N115 20mM sodium pyruvate nasal spray 3x daily for an additional week and continue to log their symptoms. Vital signs (Blood pressure, temperature, Pulse and SaO2) will be recorded on day 7 after the first treatment and on day 14.
22
Total22

Baseline characteristics

CharacteristicTreatment of COVID19 Long Haulers With Sodium Pyruvate Nasal Spray
Age, Continuous31.68 years
STANDARD_DEVIATION 9.25
Race and Ethnicity Not Collected— Participants
Region of Enrollment
United States
22 Participants
Sex: Female, Male
Female
11 Participants
Sex: Female, Male
Male
11 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
0 / 220 / 22
other
Total, other adverse events
0 / 220 / 22
serious
Total, serious adverse events
0 / 220 / 22

Outcome results

Primary

Change in Blood Oxygenation in Long COVID-19 Patients

Blood oxygenation will be measured as %O2 saturation.

Time frame: Day 1 (1st day Baseline), Day 8 (8th day Baseline), Day 8 (1st day Post-treatment) and Day 14 (7th day post-treatment)

ArmMeasureGroupValue (MEAN)Dispersion
Long COVID-19, Treatment With 20mM Sodium Pyruvate Nasal SprayChange in Blood Oxygenation in Long COVID-19 PatientsInitial reading (day 1 baseline and day 8 treatment)96.59 % Blood oxygen saturationStandard Deviation 1.098
Long COVID-19, Treatment With 20mM Sodium Pyruvate Nasal SprayChange in Blood Oxygenation in Long COVID-19 PatientsSecond reading (day 8 baseline and day 14 treatment)97.59 % Blood oxygen saturationStandard Deviation 0.6661
Long COVID-19, No Treatment (Baseline)Change in Blood Oxygenation in Long COVID-19 PatientsInitial reading (day 1 baseline and day 8 treatment)95.95 % Blood oxygen saturationStandard Deviation 0.8985
Long COVID-19, No Treatment (Baseline)Change in Blood Oxygenation in Long COVID-19 PatientsSecond reading (day 8 baseline and day 14 treatment)96.09 % Blood oxygen saturationStandard Deviation 0.9211
p-value: <0.0001ANOVA
Comparison: Day 1 baseline (day 1 of study) vs Day 1 treatment (day 7 of study).p-value: 0.0008Tukey's HSD
Comparison: Day 1 baseline (day 1 of study) vs Day 7 treatment (day 14 of study).p-value: <0.0001Tukey's HSD
Comparison: Day 7 baseline (day 7 of study) vs Day 1 treatment (day 7 of study).p-value: 0.0114Tukey's HSD
Comparison: Day7 baseline (day 7 of study) vs Day 7 treatment (day 14 of study)p-value: <0.0001Tukey's HSD
Primary

Change in Body Temperature in Long COVID-19 Patients

Body temperature will be measured twice daily by thermometer in degrees Fahrenheit. Average body temperature for the first 7 days (days 1-7) was used as a baseline with no treatment and was compared to the average body temperature for the next 7 days (days 8-14) with 20mM sodium pyruvate treatment.

Time frame: 14 days

ArmMeasureValue (MEAN)Dispersion
Long COVID-19, Treatment With 20mM Sodium Pyruvate Nasal SprayChange in Body Temperature in Long COVID-19 Patients98.41 Degrees FahrenheitStandard Deviation 0.1076
Long COVID-19, No Treatment (Baseline)Change in Body Temperature in Long COVID-19 Patients98.67 Degrees FahrenheitStandard Deviation 0.1866
p-value: <0.0001t-test, 2 sided
Primary

Change in Pulse Rate in Long COVID-19 Patients

Patient heart rate will be measured as beats per minute.

Time frame: Day 1 (1st day Baseline), Day 8 (8th day Baseline), Day 8 (1st day Post-treatment) and Day 14 (7th day post-treatment)

ArmMeasureGroupValue (MEAN)Dispersion
Long COVID-19, Treatment With 20mM Sodium Pyruvate Nasal SprayChange in Pulse Rate in Long COVID-19 PatientsInitial reading (day 1 baseline and day 8 treatment)80.38 Beats/minuteStandard Deviation 1.499
Long COVID-19, Treatment With 20mM Sodium Pyruvate Nasal SprayChange in Pulse Rate in Long COVID-19 PatientsSecond reading (day 8 baseline and day 14 treatment)79.90 Beats/minuteStandard Deviation 1.841
Long COVID-19, No Treatment (Baseline)Change in Pulse Rate in Long COVID-19 PatientsInitial reading (day 1 baseline and day 8 treatment)81.10 Beats/minuteStandard Deviation 3.463
Long COVID-19, No Treatment (Baseline)Change in Pulse Rate in Long COVID-19 PatientsSecond reading (day 8 baseline and day 14 treatment)81.14 Beats/minuteStandard Deviation 2.33
p-value: 0.1963ANOVA
Primary

Change in the Symptoms of Long COVID-19 Patients

A patient log was used to measure body ache, headache, chills, coughing/sneezing, sore throat, congestion, trouble breathing and other (patient supplied). The patients used a Likert scale from 0 to 10 to assess symptoms with 10 representing the most severe symptom and zero no symptom. The score for each individual symptom was combined into one overall symptom score for the 7 days of baseline (days 1-7) and a separate score for the 7 days of treatment (days 8-14). Therefore, a maximum 7-day score was 70 and a minimum of 0 was possible.

Time frame: 14 days

Population: Patient scores for baseline days 1-7 of the study when the patients received no treatment were summed into one baseline score (range 0-70). Patient scores for day 8-14 of the study when the patients received 3x daily treatment with 20mM sodium pyruvate were summed into a second score (range 0-70). A Mann-Whitney test was then used to assess statistical difference between baseline and treatment.

ArmMeasureGroupValue (MEAN)Dispersion
Long COVID-19, Treatment With 20mM Sodium Pyruvate Nasal SprayChange in the Symptoms of Long COVID-19 PatientsHeadaches15.71 units on a scaleStandard Deviation 4.03
Long COVID-19, Treatment With 20mM Sodium Pyruvate Nasal SprayChange in the Symptoms of Long COVID-19 PatientsCongestion14.75 units on a scaleStandard Deviation 9.032
Long COVID-19, Treatment With 20mM Sodium Pyruvate Nasal SprayChange in the Symptoms of Long COVID-19 PatientsSore Throat9 units on a scaleStandard Deviation 0
Long COVID-19, Treatment With 20mM Sodium Pyruvate Nasal SprayChange in the Symptoms of Long COVID-19 PatientsFatigue20.67 units on a scaleStandard Deviation 2.517
Long COVID-19, Treatment With 20mM Sodium Pyruvate Nasal SprayChange in the Symptoms of Long COVID-19 PatientsCoughing/Sneezing16.09 units on a scaleStandard Deviation 8.043
Long COVID-19, Treatment With 20mM Sodium Pyruvate Nasal SprayChange in the Symptoms of Long COVID-19 PatientsLoss of Smell/Taste23.25 units on a scaleStandard Deviation 31.28
Long COVID-19, Treatment With 20mM Sodium Pyruvate Nasal SprayChange in the Symptoms of Long COVID-19 PatientsTrouble Breathing11.88 units on a scaleStandard Deviation 7.191
Long COVID-19, Treatment With 20mM Sodium Pyruvate Nasal SprayChange in the Symptoms of Long COVID-19 PatientsAnxiety24 units on a scaleStandard Deviation 5.657
Long COVID-19, Treatment With 20mM Sodium Pyruvate Nasal SprayChange in the Symptoms of Long COVID-19 PatientsBody Aches20.33 units on a scaleStandard Deviation 4.933
Long COVID-19, No Treatment (Baseline)Change in the Symptoms of Long COVID-19 PatientsAnxiety28 units on a scaleStandard Deviation 0
Long COVID-19, No Treatment (Baseline)Change in the Symptoms of Long COVID-19 PatientsBody Aches27 units on a scaleStandard Deviation 5.568
Long COVID-19, No Treatment (Baseline)Change in the Symptoms of Long COVID-19 PatientsHeadaches22.43 units on a scaleStandard Deviation 5.062
Long COVID-19, No Treatment (Baseline)Change in the Symptoms of Long COVID-19 PatientsCoughing/Sneezing28.36 units on a scaleStandard Deviation 11.59
Long COVID-19, No Treatment (Baseline)Change in the Symptoms of Long COVID-19 PatientsSore Throat3 units on a scaleStandard Deviation 0
Long COVID-19, No Treatment (Baseline)Change in the Symptoms of Long COVID-19 PatientsTrouble Breathing27.75 units on a scaleStandard Deviation 13.05
Long COVID-19, No Treatment (Baseline)Change in the Symptoms of Long COVID-19 PatientsCongestion28.25 units on a scaleStandard Deviation 19.28
Long COVID-19, No Treatment (Baseline)Change in the Symptoms of Long COVID-19 PatientsFatigue33 units on a scaleStandard Deviation 10.82
Long COVID-19, No Treatment (Baseline)Change in the Symptoms of Long COVID-19 PatientsLoss of Smell/Taste42 units on a scaleStandard Deviation 26.75
Comparison: Body Achesp-value: 0.2Wilcoxon (Mann-Whitney)
Comparison: Headachesp-value: 0.0326Wilcoxon (Mann-Whitney)
Comparison: Coughing/Sneezingp-value: 0.0043Wilcoxon (Mann-Whitney)
Comparison: Trouble Breathingp-value: 0.0003Wilcoxon (Mann-Whitney)
Comparison: Congestionp-value: 0.3714Wilcoxon (Mann-Whitney)
Comparison: Fatiguep-value: 0.3Wilcoxon (Mann-Whitney)
Comparison: Loss of Smell/Tastep-value: 0.2286Wilcoxon (Mann-Whitney)
Comparison: Anxietyp-value: 0.999Wilcoxon (Mann-Whitney)

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026