Reduction of SARS-CoV-2 viral load in saliva after rinsing with mouthwashes containing cetylpyridinium chloride: a randomized clinical study
Leticia M Bezinelli, Luciana Corrêa, Stephany Beyerstedt, Marcella L Franco, Érika B Rangel, Carlos Guillermo Benítez, Nelson Hamerschlak, João R R Pinho, Debora Heller, Fernanda P Eduardo
PeerJ, doi:10.7717/peerj.15080
Background. Symptomatic patients with COVID-19 typically have a high SARS-CoV-2 viral load in their saliva. Procedures to reduce the viral load in their oral cavity are important for mitigating the viral transmission. Methods. This randomized clinical trial investigated the impact of two mouthwashes (0.075% cetylpyridinium chloride plus 0.28% zinc lactate (CPC+Zn) (n = 32), and 0.075% cetylpyridinium chloride (CPC) (n = 31)) on the viral load of SARS-CoV-2 in saliva when compared to the distilled water negative control (n = 32). Saliva was collected before (T0) and after (5 min, T1; 30 min, T2; and 60 min, T3) the intervention. Viral load in saliva was measured by qRT-PCR assays. The data in both groups was normalized for T0 and Negative Control, resulting in fold change values. Results. CPC+Zn oral solution reduced the viral load in saliva by 6.34-fold at T1, 3.6fold at T2 and 1.9-fold at T3. Rinsing with the CPC mouthwash reduced the viral load in saliva by 2.5-fold at T1, 1.9-fold at T2 and 2.0-fold at T3. Conclusion. CPC+Zn mouthwash or with the CPC mouthwash reduced the viral load in saliva of COVID-19 patients immediately after rinsing. These reductions extended up to 60 min.
ADDITIONAL INFORMATION AND DECLARATIONS Funding The study was funded by the Colgate-Palmolive Company and the Latin American Oral Health Association. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Grant Disclosures The following grant information was disclosed by the authors: Colgate-Palmolive Company and Latin American Oral Health Association.
Competing Interests The authors declare there are no competing interests.
Author Contributions • Leticia M. Bezinelli conceived and designed the experiments, analyzed the data, authored or reviewed drafts of the article, and approved the final draft. • Luciana Corrêa conceived and designed the experiments, analyzed the data, prepared figures and/or tables, authored or reviewed drafts of the article, and approved the final draft. • Stephany Beyerstedt performed the experiments, authored or reviewed drafts of the article, and approved the final draft. • Marcella L. Franco performed the experiments, authored or reviewed drafts of the article, and approved the final draft. • Érika B. Rangel analyzed the data, authored or reviewed drafts of the article, and approved the final draft. • Carlos Guillermo Benítez performed the experiments, analyzed the data, prepared figures and/or tables, authored or reviewed drafts of the article, and approved the final draft. • Nelson Hamerschlak conceived and designed the experiments, authored or reviewed drafts of the..
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'abstract': '<jats:sec>\n'
' <jats:title>Background</jats:title>\n'
' <jats:p>Symptomatic patients with COVID-19 typically have a high SARS-CoV-2 '
'viral load in their saliva. Procedures to reduce the viral load in their oral cavity are '
'important for mitigating the viral transmission.</jats:p>\n'
' </jats:sec>\n'
' <jats:sec>\n'
' <jats:title>Methods</jats:title>\n'
' <jats:p>This randomized clinical trial investigated the impact of two '
'mouthwashes (0.075% cetylpyridinium chloride plus 0.28% zinc lactate (CPC+Zn) '
'(<jats:italic>n</jats:italic>\xa0=\xa032), and 0.075% cetylpyridinium chloride (CPC) '
'(<jats:italic>n</jats:italic>\xa0=\xa031)) on the viral load of SARS-CoV-2 in saliva when '
'compared to the distilled water negative control (<jats:italic>n</jats:italic>\xa0=\xa032). '
'Saliva was collected before (T0) and after (5 min, T1; 30 min, T2; and 60 min, T3) the '
'intervention. Viral load in saliva was measured by qRT-PCR assays. The data in both groups '
'was normalized for T0 and Negative Control, resulting in fold change values.</jats:p>\n'
' </jats:sec>\n'
' <jats:sec>\n'
' <jats:title>Results</jats:title>\n'
' <jats:p>CPC+Zn oral solution reduced the viral load in saliva by 6.34-fold at '
'T1, 3.6-fold at T2 and 1.9-fold at T3. Rinsing with the CPC mouthwash reduced the viral load '
'in saliva by 2.5-fold at T1, 1.9-fold at T2 and 2.0-fold at T3.</jats:p>\n'
' </jats:sec>\n'
' <jats:sec>\n'
' <jats:title>Conclusion</jats:title>\n'
' <jats:p>CPC+Zn mouthwash or with the CPC mouthwash reduced the viral load in '
'saliva of COVID-19 patients immediately after rinsing. These reductions extended up to 60 '
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