Rationale: Super acidic (pH<2.7) electrolyzed saline (ES) is a non-toxic and all-purpose disinfectant for viruses, bacteria and fungi. The effect of gargling ES was  investigated in COVID-19.

Patients and Methods: Three patients with/without pneumonia were admitted since June 8, 2021. Treatment strategies followed to the Japanese Guidelines for Acute Respiratory Distress Syndrome 2016 with modifications for remote treatment. ES gargling were used to decontaminate the primary infection site. Each patient gargled a glass of ES on the day of admission (day 1), and then gargled half a glass of ES 3 times a day for the following 3 days.

Results: Gargling ES resulted in a prompt (within a week) reduction in salivary SARS-CoV-2 antigen levels, and all 3 patients recovered and were released from quarantine within 2 weeks.

Conclusions: Non-specific virucidal activity of ES was reconfirmed in COVID-19. ES gargling will suppress disease progression and transmission of COVID-19.