Conv. Plasma
Nigella Sativa

All hydrogen peroxide studies
Meta analysis
study COVID-19 treatment researchHydrogen PeroxideHydrogen Per.. (more..)
Melatonin Meta
Metformin Meta
Azvudine Meta
Bromhexine Meta Molnupiravir Meta
Budesonide Meta
Colchicine Meta
Conv. Plasma Meta Nigella Sativa Meta
Curcumin Meta Nitazoxanide Meta
Famotidine Meta Paxlovid Meta
Favipiravir Meta Quercetin Meta
Fluvoxamine Meta Remdesivir Meta
Hydroxychlor.. Meta Thermotherapy Meta
Ivermectin Meta

All Studies   Meta Analysis    Recent:   
0 0.5 1 1.5 2+ Viral load, 60 min 72% Improvement Relative Risk Viral load, 30 min 77% Viral load, immediately 73% Hydrogen Peroxide  Bezinelli et al.  INTUBATED PATIENTS  DB RCT Does very late treatment with hydrogen peroxide + chlorhexidine reduce short-term viral load? Double-blind RCT 48 patients in Brazil (May - July 2020) Improved viral clearance with hydrogen peroxide + chlorhexidine (not stat. sig., p=0.49) Bezinelli et al., J. Oral Microbiology, Dec 2022 Favors hydrogen peroxide Favors control

Antimicrobial oral lavage reduces the SARS-CoV-2 load in intubated patients: randomized clinical trial

Bezinelli et al., Journal of Oral Microbiology, doi:10.1080/20002297.2022.2152179, NCT04537962
Dec 2022  
  Source   PDF   All   Meta
19th treatment shown to reduce risk in May 2021
*, now known with p = 0.029 from 7 studies.
Lower risk for viral clearance.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,100+ studies for 60+ treatments.
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 Alemany, Tarragó‐Gil 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.
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:
This PaperHydrogen Per..All
Antimicrobial oral lavage reduces the SARS-CoV-2 load in intubated patients: randomized clinical trial
Letícia Mello Bezinelli, Luciana Corrêa, Stephany Beyerstedt, Érika Bevilaqua Rangel, Carlos Benitez, Nelson Hamerschlak, João Renato Rebello Pinho, Debora Heller, Fernanda De Paula Eduardo
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.
Aoki, De Oliveira Coelho, Góes, Colorimetric RT-LAMP SARS-CoV-2 diagnostic sensitivity relies on color interpretation and viral load, Sci Rep
Araujo, Machado, Amgarten, SARS-CoV-2 isolation from the first reported patients in Brazil and establishment of a coordinated task network, Mem Inst Oswaldo Cruz
Costa, Brites, Vaz, Chlorhexidine mouthwash reduces the salivary viral load of SARS-CoV-2: a randomized clinical trial. Oral Dis, doi:10.1111/odi.14086
Cousido, Carmona, García-Caballero, In vivo substantivity of 0.12% and 0.2% chlorhexidine mouthrinses on salivary bacteria, Clin Oral Investig
Davies, Buczkowski, Welch, Effective in vitro inactivation of SARS-CoV-2 by commercially available mouthwashes, J Gen Virol
Eduardo, Corrêa, Heller, Salivary SARS-CoV-2 load reduction with mouthwash use: a randomized pilot clinical trial, Heliyon
Fernandes, Pacheco, Borges, Saliva in the diagnosis of COVID-19: a review and new research directions, J Dent Res
Huang, Huang, Use of chlorhexidine to eradicate oropharyngeal SARS-CoV-2 in COVID-19 patients, J Med Virol
Huang, Pérez, Kato, SARS-CoV-2 infection of the oral cavity and saliva, Nat Med
Illingworth, Hamilton, Warne, Superspreaders drive the largest outbreaks of hospital onset COVID-19 infections, eLife
Jain, Grover, Singh, Chlorhexidine: an effective anticovid mouth rinse, J Indian Soc Periodontol
Kampf, Potential role of inanimate surfaces for the spread of coronaviruses and their inactivation with disinfectant agents, Infect Prev Pract, doi:10.1016/j.infpip.2020.100044
Lavorini, Usmani, Dhand, Aerosol delivery systems for treating obstructive airway diseases during the SARS-CoV-2 pandemic, Intern Emerg Med
Linley, Denyer, Mcdonnell, Use of hydrogen peroxide as a biocide: new consideration of its mechanisms of biocidal action, J Antimicrob Chemother
Meister, Brüggemann, Todt, Virucidal efficacy of different oral rinses against severe acute respiratory syndrome coronavirus 2, J Infect Dis
Nestor, Wang, Irwin, Are tracheal intubation and extubation aerosol-generating procedures?, Anaesthesia
Nseir, Martin-Loeches, Povoa, Relationship between ventilator-associated pneumonia and mortality in COVID-19 patients: a planned ancillary analysis of the coVAPid cohort, Crit Care
Steinhauer, Meister, Todt, Comparison of the in-vitro efficacy of different mouthwash solutions targeting SARS-CoV-2 based on the European standard EN 14476, J Hosp Infect
Yoon, Yoon, Song, Clinical significance of a high SARS-CoV-2 viral load in the saliva, J Korean Med Sci
Zhao, Wu, Zhang, Oral hygiene care for critically ill patients to prevent ventilator-associated pneumonia, Cochrane Database Syst Rev
Zhu, Guo, Xu, Viral dynamics of SARS-CoV-2 in saliva from infected patients, J Infect
{ 'DOI': '10.1080/20002297.2022.2152179', 'ISSN': ['2000-2297'], 'URL': '', 'alternative-id': ['10.1080/20002297.2022.2152179'], 'assertion': [ { 'label': 'Peer Review Statement', 'name': 'peerreview_statement', 'order': 1, 'value': 'The publishing and review policy for this title is described in its Aims & ' 'Scope.'}, { 'URL': '', 'label': 'Aim & Scope', 'name': 'aims_and_scope_url', 'order': 2, 'value': ''}, { 'group': {'label': 'Publication History', 'name': 'publication_history'}, 'label': 'Received', 'name': 'received', 'order': 0, 'value': '2022-09-13'}, { 'group': {'label': 'Publication History', 'name': 'publication_history'}, 'label': 'Revised', 'name': 'revised', 'order': 1, 'value': '2022-11-22'}, { 'group': {'label': 'Publication History', 'name': 'publication_history'}, 'label': 'Accepted', 'name': 'accepted', 'order': 2, 'value': '2022-11-22'}, { 'group': {'label': 'Publication History', 'name': 'publication_history'}, 'label': 'Published', 'name': 'published', 'order': 3, 'value': '2022-12-13'}], 'author': [ { 'ORCID': '', 'affiliation': [{'name': 'Hospital Israelita Albert Einstein, São Paulo, Brazil'}], 'authenticated-orcid': False, 'family': 'Bezinelli', 'given': 'Letícia Mello', 'sequence': 'first'}, { 'ORCID': '', 'affiliation': [{'name': 'School of Dentistry, University of São Paulo, São Paulo, Brazil'}], 'authenticated-orcid': False, 'family': 'Corrêa', 'given': 'Luciana', 'sequence': 'additional'}, { 'ORCID': '', 'affiliation': [{'name': 'Hospital Israelita Albert Einstein, São Paulo, Brazil'}], 'authenticated-orcid': False, 'family': 'Beyerstedt', 'given': 'Stephany', 'sequence': 'additional'}, { 'ORCID': '', 'affiliation': [ {'name': 'Hospital Israelita Albert Einstein, São Paulo, Brazil'}, { 'name': 'Nephorology Division, Federal University of Sao Paulo, São ' 'Paulo, Brazil'}], 'authenticated-orcid': False, 'family': 'Rangel', 'given': 'Érika Bevilaqua', 'sequence': 'additional'}, { 'ORCID': '', 'affiliation': [{'name': 'Latin American Oral Health Association, São Paulo, Brazil'}], 'authenticated-orcid': False, 'family': 'Benitez', 'given': 'Carlos', 'sequence': 'additional'}, { 'ORCID': '', 'affiliation': [{'name': 'Hospital Israelita Albert Einstein, São Paulo, Brazil'}], 'authenticated-orcid': False, 'family': 'Hamerschlak', 'given': 'Nelson', 'sequence': 'additional'}, { 'ORCID': '', 'affiliation': [{'name': 'Hospital Israelita Albert Einstein, São Paulo, Brazil'}], 'authenticated-orcid': False, 'family': 'Pinho', 'given': 'João Renato Rebello', 'sequence': 'additional'}, { 'ORCID': '', 'affiliation': [ {'name': 'Hospital Israelita Albert Einstein, São Paulo, Brazil'}, { 'name': 'Postgraduate Program in Dentistry, Universidade Cruzeiro do Sul, ' 'São Paulo, Brazil'}, { 'name': 'Department of Periodontology, School of Dentistry, The ' 'University of Texas Health Science Center at San Antonio, San ' 'Antonio, Texas, USA'}], 'authenticated-orcid': False, 'family': 'Heller', 'given': 'Debora', 'sequence': 'additional'}, { 'ORCID': '', 'affiliation': [{'name': 'Hospital Israelita Albert Einstein, São Paulo, Brazil'}], 'authenticated-orcid': False, 'family': 'Eduardo', 'given': 'Fernanda de Paula', 'sequence': 'additional'}], 'container-title': 'Journal of Oral Microbiology', 'container-title-short': 'Journal of Oral Microbiology', 'content-domain': {'crossmark-restriction': True, 'domain': ['']}, 'created': { 'date-parts': [[2022, 12, 14]], 'date-time': '2022-12-14T07:53:22Z', 'timestamp': 1671004402000}, 'deposited': { 'date-parts': [[2023, 3, 17]], 'date-time': '2023-03-17T18:33:50Z', 'timestamp': 1679078030000}, 'funder': [ { 'DOI': '10.13039/100004368', 'doi-asserted-by': 'publisher', 'name': 'Colgate-Palmolive Company'}], 'indexed': {'date-parts': [[2023, 3, 17]], 'date-time': '2023-03-17T19:11:15Z', 'timestamp': 1679080275988}, 'is-referenced-by-count': 0, 'issue': '1', 'issued': {'date-parts': [[2022, 12, 13]]}, 'journal-issue': {'issue': '1', 'published-print': {'date-parts': [[2023, 12, 31]]}}, 'language': 'en', 'license': [ { 'URL': '', 'content-version': 'unspecified', 'delay-in-days': 0, 'start': { 'date-parts': [[2022, 12, 13]], 'date-time': '2022-12-13T00:00:00Z', 'timestamp': 1670889600000}}], 'link': [ { 'URL': '', 'content-type': 'unspecified', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'member': '301', 'original-title': [], 'prefix': '10.1080', 'published': {'date-parts': [[2022, 12, 13]]}, 'published-online': {'date-parts': [[2022, 12, 13]]}, 'published-print': {'date-parts': [[2023, 12, 31]]}, 'publisher': 'Informa UK Limited', 'reference': [ {'DOI': '10.7554/eLife.67308', 'doi-asserted-by': 'publisher', 'key': 'cit0001'}, { 'author': 'Lavorini F', 'first-page': '1', 'journal-title': 'Intern Emerg Med', 'key': 'cit0002', 'volume': '30', 'year': '2021'}, {'DOI': '10.1177/0022034520960070', 'doi-asserted-by': 'publisher', 'key': 'cit0003'}, {'DOI': '10.1038/s41591-021-01296-8', 'doi-asserted-by': 'publisher', 'key': 'cit0004'}, {'DOI': '10.1016/j.jinf.2020.06.059', 'doi-asserted-by': 'publisher', 'key': 'cit0005'}, {'DOI': '10.1111/anae.15328', 'doi-asserted-by': 'publisher', 'key': 'cit0006'}, { 'DOI': '10.1186/s13054-021-03588-4', 'author': 'Nseir S', 'doi-asserted-by': 'crossref', 'first-page': '177', 'issue': '1', 'journal-title': 'Crit Care', 'key': 'cit0007', 'volume': '25', 'year': '2021'}, { 'author': 'Zhao T', 'first-page': 'CD008367', 'issue': '12', 'journal-title': 'Cochrane Database Syst Rev', 'key': 'cit0008', 'volume': '12', 'year': '2020'}, {'DOI': '10.1099/jgv.0.001578', 'doi-asserted-by': 'publisher', 'key': 'cit0009'}, {'DOI': '10.1016/j.jhin.2021.01.031', 'doi-asserted-by': 'publisher', 'key': 'cit0010'}, { 'DOI': '10.4103/jisp.jisp_824_20', 'author': 'Jain A', 'doi-asserted-by': 'crossref', 'first-page': '86', 'issue': '1', 'journal-title': 'J Indian Soc Periodontol', 'key': 'cit0011', 'volume': '25', 'year': '2021'}, {'DOI': '10.1093/infdis/jiaa471', 'doi-asserted-by': 'publisher', 'key': 'cit0012'}, {'DOI': '10.1002/jmv.26954', 'doi-asserted-by': 'publisher', 'key': 'cit0013'}, {'DOI': '10.1111/odi.14086', 'doi-asserted-by': 'publisher', 'key': 'cit0014'}, {'DOI': '10.3346/jkms.2020.35.e195', 'doi-asserted-by': 'publisher', 'key': 'cit0015'}, {'DOI': '10.1016/j.heliyon.2021.e07346', 'doi-asserted-by': 'publisher', 'key': 'cit0016'}, {'DOI': '10.1016/j.infpip.2020.100044', 'doi-asserted-by': 'publisher', 'key': 'cit0017'}, { 'DOI': '10.1590/0074-02760200342', 'author': 'Araujo DB', 'doi-asserted-by': 'crossref', 'first-page': 'e200342', 'issue': '115', 'journal-title': 'Mem Inst Oswaldo Cruz', 'key': 'cit0018', 'volume': '23', 'year': '2020'}, {'DOI': '10.1038/s41598-021-88506-y', 'doi-asserted-by': 'publisher', 'key': 'cit0019'}, {'DOI': '10.1093/jac/dks129', 'doi-asserted-by': 'publisher', 'key': 'cit0020'}, {'DOI': '10.1007/s00784-009-0320-2', 'doi-asserted-by': 'publisher', 'key': 'cit0021'}], 'reference-count': 21, 'references-count': 21, 'relation': {}, 'resource': {'primary': {'URL': ''}}, 'score': 1, 'short-title': [], 'source': 'Crossref', 'subject': ['Infectious Diseases', 'Microbiology (medical)', 'Dentistry (miscellaneous)'], 'subtitle': [], 'title': 'Antimicrobial oral lavage reduces the SARS-CoV-2 load in intubated patients: randomized clinical ' 'trial', 'type': 'journal-article', 'update-policy': '', 'volume': '15'}
Late treatment
is less effective
Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
  or use drag and drop