Antimicrobial oral lavage reduces the SARS-CoV-2 load in intubated patients: randomized clinical trial
et al., Journal of Oral Microbiology, doi:10.1080/20002297.2022.2152179, NCT04537962, Dec 2022
24th treatment shown to reduce risk in
May 2021, now with p = 0.024 from 8 studies.
Lower risk for viral clearance.
No treatment is 100% effective. Protocols
combine treatments.
6,200+ studies for
200+ treatments. c19early.org
|
RCT 24 intubated patients treated with hydrogen peroxide + chlorhexidine oral rinse, and 19 with chlorhexidine, showing viral load reductions immediately after and 30/60 minutes later, with statistical significance only for immediate reduction with hydrogen peroxide + chlorhexidine.
Analysis of short-term changes in viral load using PCR may not detect
effective treatments because PCR is unable to differentiate between intact
infectious virus and non-infectious or destroyed virus particles. For example
Tarragó-Gil, Alemany perform RCTs with cetylpyridinium chloride
(CPC) mouthwash that show no difference in PCR viral load, however there was
significantly increased detection of SARS-CoV-2 nucleocapsid protein,
indicating viral lysis. CPC inactivates SARS-CoV-2 by degrading its membrane,
exposing the nucleocapsid of the virus. To better estimate changes in viral
load and infectivity, methods like viral culture that can
differentiate intact vs. degraded virus are preferred.
This study is excluded in meta
analysis:
study only provides PCR-based short-term viral load results.
|
viral load, 72.3% lower, relative load 0.28, p = 0.49, treatment 24, control 24, 60 min.
|
|
viral load, 76.6% lower, relative load 0.23, p = 0.12, treatment 24, control 24, 30 min.
|
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viral load, 73.2% lower, relative load 0.27, p = 0.02, treatment 24, control 24, immediately.
|
| Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates |
Bezinelli et al., 13 Dec 2022, Double Blind Randomized Controlled Trial, Brazil, peer-reviewed, 9 authors, study period May 2020 - July 2020, this trial uses multiple treatments in the treatment arm (combined with chlorhexidine) - results of individual treatments may vary, trial NCT04537962 (history).
Contact: debora_heller@hotmail.com.
Antimicrobial oral lavage reduces the SARS-CoV-2 load in intubated patients: randomized clinical trial
Journal of Oral Microbiology, doi:10.1080/20002297.2022.2152179
Background: The oral cavity can be a reservoir for SARS-CoV-2 and may play a crucial role in the viral transmission in the hospital environment. Objective: To investigate whether an oral hygiene protocol with chlorhexidine (CHX) used alone and in combination with hydrogen peroxide (HP) in the intensive care unit was effective in reducing the SARS-CoV-2 viral load in the oral cavity. Methods: SARS-CoV-2 viral load was measured on oral fluid samples collected from patients undergoing orotracheal intubation. The study sample was randomly in: CHX group (n = 19)oral rinse using only 0.12% CHX solution; HP+CHX group (n = 24) -oral rinse with 1.5% HP and 0.12% CHX. The samples were collected before the interventions (T0), immediately (T1), 30 minutes (T2) and 60 minutes (T3) after the procedure. Results: A significant viral load reduction was observed at T1 (mean ± SD:-0.57 ± 0.19 log10;-73.2%;p = 0.022) in the HP+CHX group. No statistically significant differences between any time points were observed in the CHX group.
Conclusion: The HP+CHX oral rinses significantly reduced the SARS-CoV-2 viral load in the oral fluid immediately after the procedure. The CHX oral rinse alone did not result in any significant viral load reductions.
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Late treatment
is less effective
is less effective
