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0 0.5 1 1.5 2+ Recovery, day 4 16% Improvement Relative Risk Recovery, day 18 -40% Recovery, day 12 13% Recovery, day 10 61% Recovery, day 8 67% Recovery, day 6 -3% Recovery, day 4 (b) 16% Recovery, day 2 -68% Improvement in viral load 73% Time to viral- 22% Povidone-Iodine  Alsaleh et al.  EARLY TREATMENT  RCT Is early treatment with povidone-iodine beneficial for COVID-19? RCT 13 patients in Saudi Arabia (August 2021 - July 2022) No significant difference in outcomes seen Alsaleh et al., Research Square, December 2023 Favors povidone-iodine Favors control

Efficacy of Povidone-Iodine Nasal Rinse and Mouth Wash in COVID-19 Management: A Prospective, Randomized Pilot Clinical Trial (Povidone-Iodine in COVID-19 Management)

Alsaleh et al., Research Square, doi:10.21203/, NCT04449965
Dec 2023  
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PVP-I for COVID-19
13th treatment shown to reduce risk in February 2021
*, now known with p = 0.000000037 from 20 studies.
Lower risk for mortality, cases, and viral clearance.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
3,800+ studies for 60+ treatments.
Tiny RCT with 5 PVP-I patients, 6 saline patients, and 8 control patients, showing improved viral clearance with 0.23% povidone-iodine (PVP-I) nasal rinses and mouthwashes. No significant differences were found for viral load by PCR cycle threshold values or patient-reported symptom scales.
Authors claim the trial is placebo controlled, however they state that the control group "did not receive any intervention".
WURSS-11 was higher in the PVP-I group vs. control at baseline (29 vs. 24).
Authors report that patients developed symptoms within the last three days, however the mean baseline Ct for the PVP-I group was 23, indicating high viral load and suggesting later treatment.
Figure 1 shows patients lost to followup in both the PVP-I and NS groups. For PVP-I, Figure 2 indicates a patient censored at day 4 and only 4 patients with further data, but Table 2 shows a mean viral clearance of 9.8 days from 5 patients.
risk of no recovery, 16.4% lower, RR 0.84, p = 0.76, treatment mean 4.6 (±4.0) n=4, control mean 5.5 (±5.0) n=8, mid-recovery, day 4.
risk of no recovery, 40.0% higher, RR 1.40, p = 0.73, treatment mean 2.8 (±4.0) n=4, control mean 2.0 (±3.5) n=8, day 18.
risk of no recovery, 13.0% lower, RR 0.87, p = 0.89, treatment mean 2.0 (±1.0) n=4, control mean 2.3 (±4.0) n=8, day 12.
risk of no recovery, 61.4% lower, RR 0.39, p = 0.28, treatment mean 2.7 (±3.0) n=4, control mean 7.0 (±7.1) n=8, day 10.
risk of no recovery, 66.7% lower, RR 0.33, p = 0.36, treatment mean 1.0 (±1.0) n=4, control mean 3.0 (±4.0) n=8, inverted to make RR<1 favor treatment, day 8.
risk of no recovery, 3.1% higher, RR 1.03, p = 0.96, treatment mean 3.3 (±3.0) n=4, control mean 3.2 (±3.0) n=8, day 6.
risk of no recovery, 16.4% lower, RR 0.84, p = 0.76, treatment mean 4.6 (±4.0) n=4, control mean 5.5 (±5.0) n=8, day 4.
risk of no recovery, 68.0% higher, RR 1.68, p = 0.07, treatment mean 16.3 (±6.0) n=4, control mean 9.7 (±5.0) n=8, day 2.
relative improvement in viral load, 72.7% better, RR 0.27, p = 0.72, treatment mean 2.2 (±4.88) n=5, control mean 0.6 (±8.7) n=8, day 4.
time to viral-, 22.2% lower, relative time 0.78, p = 0.02, treatment mean 9.8 (±1.6) n=4, control mean 12.6 (±1.68) n=8.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Alsaleh et al., 6 Dec 2023, Randomized Controlled Trial, Saudi Arabia, preprint, median age 38.0, 9 authors, study period August 2021 - July 2022, trial NCT04449965 (history). Contact:
This PaperPovidone-Iod..All
Efficacy of Povidone-Iodine Nasal Rinse and Mouth Wash in COVID-19 Management: A Prospective, Randomized Pilot Clinical Trial (Povidone-Iodine in COVID-19 Management)
Saad Alsaleh, Ahmed Alhussien, Abduljabbar Alyamani, Fahad Alhussain, Ali Alhijji, Khalifa Binkhamis, Anas Khan, Amin Javer, Fatimah Al-Shahrani
Objectives/Hypothesis: To assess the e cacy of 0.23% povidone-iodine (PVP-I) nasal rinses and mouth washes on detectability of the coronavirus disease 2019 (COVID-19) virus and cycle threshold (Ct) values in nasopharyngeal swabs. Study Design: This was an open-label, prospective, randomized, placebo-controlled clinical trial.
Declarations Ethics approval and consent to participate The study was approved by the King Saud University Institutional Review Board and the Saudi Food and Drug Authority Clinical Trial Unit. All patients who met the inclusion criteria signed a written informed consent form that mentioned possible risks and bene ts associated with the intervention. Consent for publication Not applicable Competing interests The authors declare that they have no competing interests Authors' contributions Saad Alsaleh (SA) and Amin Javer (AJ) conceptualized the study. Ahmed Alhussien (AH) curated the data and performed formal analysis. SA secured funding for the project. AH, Abduljabbar Alyamani (AY), Fahad Alhussain (FA), Ali Alhijji (AJ), and Khalifa Binkhamis (KB) contributed to the investigation. SA, AJ, KB, Anas Khan (AK), and Fatimah Al-Shahrani (FA) contributed to the methodology. AH, AJ, and KB were involved in project administration. SA, KB, AK, and FA provided resources. AH developed the software. SA supervised the project. KB validated the ndings. SA visualized the data. AH, AY, and FA drafted the original manuscript. SA, KB, and AJ reviewed and edited the manuscript. All authors reviewed the nal manuscript. Compliance with ethical standards Con ict of interest: Authors have no con icts of interest. Ethical approval: The study was approved by the King Saud University Institutional Review Board and the Saudi Food and Drug Authority Clinical Trial Unit. Statements and..
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