Hydrogen Therapy and Its Future Prospects for Ameliorating COVID-19: Clinical Applications, Efficacy, and Modality.

Abstract

This review examines the biological properties and potential applications of molecular hydrogen (H₂) with particular emphasis on COVID-19 pneumonia. Because of its low molecular weight, H₂ diffuses readily across cell membranes and exerts antioxidant, anti-inflammatory, and anti-apoptotic effects. Key mechanisms include suppression of excess reactive oxygen species and modulation of nuclear transcription factors. Evidence from clinical trials and animal experiments indicates relevance across a spectrum of conditions such as sepsis, ischemia-reperfusion injury, pancreatitis, and respiratory disorders. Three principal delivery routes are discussed: gas inhalation, oral hydrogen-rich water, and intravenous hydrogen-rich saline. The review also addresses H₂ involvement in mitochondrial energy metabolism and regulated cell death pathways including apoptosis, pyroptosis, and autophagy. China's clinical guidelines recommending H₂ inhalation for COVID-19 pneumonia are noted, and the overall safety profile is considered favorable, though the precise molecular mechanisms remain incompletely characterized.

Mechanism

H₂ selectively scavenges excess reactive oxygen species and modulates nuclear transcription factors, producing anti-inflammatory and anti-apoptotic effects; it also influences mitochondrial energy metabolism and regulated cell death pathways including autophagy and pyroptosis.