Impact of steam inhalation, saline gargling, and povidone-iodine gargling on clinical outcome of COVID-19 patients in Bengaluru, Karnataka: A randomized control trial
Dr S Saraswathi, Vani H Chalageri, Shobha Bhushan, T S Ranganath, Vdevika Rani, Sumanthmallikarjuna Majgi, Kariyappa Vijay, M S Hema, Shwetalaxman Sanadi, P M Nasreen, Kmd Shoyaib, Iswarya Partheeban, B Vanitha, Neha D Souza, Jyoti S Vaddatti
Indian Journal of Community Medicine, doi:10.4103/ijcm.ijcm_804_21
IntRoductIon The WHO declared COVID-19 as a pandemic on March 11, 2020. [1] As the pandemic progressed and with better understanding of the disease, it was realized that asymptomatic, mild-and-moderate cases could be managed under home isolation. Accordingly, Indian government changed the guidelines from institution isolation to home-based care [2] to reduce the burden on the health-care system. COVID-19 is an infectious viral disease with respiratory droplets as the main transmission route. The initial viral load in the nasopharyngeal specimens is a predictor of clinical outcome with respect to severity, disease progression, and mortality which in turn makes it very important to intervene in the early stage of the disease. [3] The viral load in throat swabs is highest just before symptom onset, and peak infectivity is seen on or before the onset of symptoms and viral load declines gradually by day 21. [4] Context: In the absence of any specific treatment available for COVID-19, people started practicing traditional nonpharmacological preventive home remedies such as salt water gargling and steam inhalation. The available research evidence on some of these measures opines that steam inhalation, saline gargling, and povidone-iodine gargling does have virucidal properties and do provide symptomatic relief. Aims: The aim is to test this hypothesis, and the present trial was undertaken with an objective to assess the effect of steam inhalation, saline gargling, and povidone-iodine gargling among the COVID-19-positive patients with respect to early test negativity and clinical recovery. Methodology: Open-labeled, parallel, randomized controlled trial was conducted among asymptomatic or mild COVID-19-positive patients in Bangalore from September 2020 to February 2021. In each group of steam inhalation, saline gargling, povidone-iodine gargling, and control, twenty participants were allocated. Daily follow-up was done for 21 days to assess early test negativity and clinical recovery. Trial Registry Number: Clinical Trial Registry India/2020/09/027687. Results: Among 80 participants recruited, 65 (81.3%) were symptomatic. Early test negativity was seen in povidone-iodine gargling group of 6 days (KaplanMeier survival curve, BreslowGeneralized Wilcoxon test P = 0.7 as per the intention-to-treat and as per-protocol P = 0.8). Significant clinical recovery was seen in saline gargling group (4 days, P = 0.01). Conclusion: Povidone-iodine gargling was effective in providing early test negativity, whereas saline gargling was effective in early clinical recovery.
Conflicts of interest There are no conflicts of interest.
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