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All Studies   All Outcomes    Recent:   
0 0.5 1 1.5 2+ Fold change relative to b.. 50% Improvement Relative Risk Cetylpyridinium Chloride  Bezinelli et al.  LATE TREATMENT  DB RCT Does late treatment with cetylpyridinium chloride reduce short-term viral load? Double-blind RCT 63 patients in Brazil Improved viral clearance with cetylpyridinium chloride (p=0.0051) c19early.org Bezinelli et al., PeerJ, December 2023 Favors cetylpyridinium chloride Favors control

Reduction of SARS-CoV-2 viral load in saliva after rinsing with mouthwashes containing cetylpyridinium chloride: a randomized clinical study

Bezinelli et al., PeerJ, doi:10.7717/peerj.15080
Dec 2023  
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RCT 95 hospitalized COVID-19 patients showing reduced salivary SARS-CoV-2 viral load after rinsing with cetylpyridinium chloride (CPC) or CPC plus zinc mouthwashes. CPC plus zinc mouthwash reduced viral load by 6.3-fold at 5 minutes, 3.6-fold at 30 minutes, and 1.9-fold at 60 minutes compared to baseline. CPC alone reduced viral load by 2.5-fold at 5 minutes, 1.9-fold at 30 minutes, and 2.0-fold at 60 minutes. Results are only provided for short-term viral load via PCR.
The paper claims inclusion of up to 7 days symptoms, but the clinical data shows many patients with longer delays, up to 11 days.
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 or antigen detection that can differentiate intact vs. degraded virus are preferred.
This study is excluded in meta analysis: study only provides short-term viral load results.
fold change relative to baseline and control, 50.0% lower, RR 0.50, p = 0.005, treatment 31, control 32, inverted to make RR<1 favor treatment, 60 min.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Bezinelli et al., 18 Dec 2023, Double Blind Randomized Controlled Trial, Brazil, peer-reviewed, 10 authors.
This PaperCetylpyridin..All
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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Late treatment
is less effective
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