Download Image
    
Share
  
Post
c19early.org
Chlorhexidine for COVID-19
5 studies with >600 patients
Serious outcome risk
Chlorhexidine
Control
Significantly lower risk for progression, cases, and viral clearance.
4 studies from 4 independent teams in 4 countries show significant benefit.
COVID-19 Chlorhexidine studies · October 2026
Recent:
Hup.
Covid Analysis Chlorhexidine reduces COVID-19 risk: real-time meta-analysis of 5 studies (Version 5)
Significantly lower risk is seen for progression, cases, and viral clearance. 4 studies from 4 independent teams in 4 countries show significant benefit. Meta-analysis using the most serious outcome reported shows 70% [58‑79%] ..
Feb 27
 Hup et al., Medical Science Monitor, doi:10.12659/MSM.950753 Efficacy of Mouthwashes Delivered via Dental Unit Waterlines in Reducing Aerosolized Surrogate SARS-CoV-2
In vitro study testing mouthwashes delivered through dental unit waterlines for reducing aerosolized surrogate SARS-CoV-2 (human coronavirus OC43). The study used suspension tests, carrier tests, and a novel 3D-printed aerosol model to ev..
Aug 8
2025
 Angjelova et al., Antibiotics, doi:10.3390/antibiotics14080815 Effects of Antiseptic Formulations on Oral Microbiota and Related Systemic Diseases: A Scoping Review
Review of oral antiseptic formulations and their effects on oral microbiota and systemic diseases. While antiseptics like chlorhexidine, essential oils, povidone-iodine, and cetylpyridinium chloride can effectively reduce pathogenic oral..
Jun 18
2025
 Thangamani et al., World Academy of Sciences Journal, doi:10.3892/wasj.2025.366 Rinsing away the threat: Antiviral mouthwashes and their efficacy
Review of antiviral mouthwashes and their efficacy against respiratory viruses, focusing on SARS-CoV-2. Authors examine povidone-iodine (PVP-I), cetylpyridinium chloride (CPC), chlorhexidine (CHX), and phthalocyanine derivatives. PVP-I sh..
Jun 10
2025
 Seijas-Otero et al., Japanese Dental Science Review, doi:10.1016/j.jdsr.2025.05.001 Antiseptics as effective virucidal agents against SARS-CoV-2: Systematic review and Bayesian network meta-analysis
Bayesian network meta-analysis of 26 studies evaluating the effectiveness of oral and nasal antiseptics against SARS-CoV-2 viral load, finding that povidone-iodine was the most effective. Hydrogen peroxide and chlorhexidine also showed si..
Apr 30
2025
 Sulistyani et al., Dental and Medical Problems, doi:10.17219/dmp/192493 Effects of chlorhexidine gluconate and povidone-iodine mouthwash on cycle threshold values in patients infected with SARS-CoV-2
54% improved viral clearance (p=0.001). Prospective study of 45 COVID-19 patients showing improved viral clearance with chlorhexidine gluconate and povidone-iodine mouthwash use.
Dec 9
2024
 Graves et al., JDR Clinical & Translational Research, doi:10.1177/23800844241296840 A Cetylpyridinium Chloride Oral Rinse Reduces Salivary Viral Load in Randomized Controlled Trials
35% improved viral clearance (p=0.91). Two RCTs with a total of 247 recently diagnosed COVID-19 patients showing a significant reduction in salivary SARS-CoV-2 viral load 30 minutes after rinsing with a cetylpyridinium chloride (CPC) mouthwash compared to rinsing with saline o..
Oct 21
2024
 Okeke et al., Current Research in Microbial Sciences, doi:10.1016/j.crmicr.2024.100293 Antiseptics: An expeditious third force in the prevention and management of coronavirus diseases
Review of the use of nasopharyngeal/oropharyngeal virucidal agents such as povidone-iodine, chlorhexidine, cetylpyridinium chloride, hydrogen peroxide, and others for preventing the spread of COVID-19 and other coronavirus diseases. Autho..
May 16
2024
 Huang et al., Journal of Dentistry, doi:10.1016/j.jdent.2024.105082 Satisfaction with Government Recommended Pre-Procedural Mouth Rinses in the Mitigation of Covid-19 in Hong Kong SAR: A Triple Blind Randomized Controlled Clinical Trial
RCT 228 dental patients showing high satisfaction and acceptability of three pre-procedural mouthrinses (povidone-iodine, hydrogen peroxide, and chlorhexidine digluconate) recommended by the Hong Kong government for mitigating COVID-19 tr..
Feb 19
2024
 Brito-Reia et al., Current Oral Health Reports, doi:10.1007/s40496-024-00368-1 Antiviral Mechanism and Clinical Benefits of Mouthwash Active Against SARS-CoV-2
Review of antiviral mechanisms and clinical benefits of mouthwashes for SARS-CoV-2, including chlorhexidine (CHX), cetylpyridinium chloride (CPC), ethyl lauroyl arginate (ELA), hydrogen peroxide (HP), povidone-iodine (PVP-I), and anionic..
Feb 16
2024
 Rius-Salvador et al., PLOS ONE, doi:10.1371/journal.pone.0297291 Cetylpyridinium chloride and chlorhexidine show antiviral activity against Influenza A virus and Respiratory Syncytial virus in vitro
In vitro study showing antiviral activity against influenza A virus and respiratory syncytial virus with cetylpyridinium chloride (CPC) and chlorhexidine (CHX). Authors found CPC and CHX decreased infectivity of both viruses by 90-99.9% d..
Jan 9
2024
 Karami et al., Iranian Journal of Nursing and Midwifery Research, doi:10.4103/ijnmr.ijnmr_38_23 A Comparison of the Effects of Chlorhexidine and Sodium Bicarbonate Mouthwashes on COVID-19–Related Symptoms
61% lower progression (p=0.04) and 57% fewer cases (p=0.03). RCT 116 healthcare workers comparing 0.2% chlorhexidine mouthwash (n=36), 7.5% sodium bicarbonate mouthwash (n=40), and placebo (n=40) twice daily for 2 weeks, with symptoms followed for 4 weeks. There were lower symtoms and cases in both..
Dec 31
2023
 Nazrine et al., Journal of Indian Society of Periodontology, doi:10.4103/jisp.jisp_469_22 In vivo efficacy of 2% povidone iodine, chlorhexidine gluconate, and herbal extract mouthwash on SARS-CoV-2 viral load in saliva: A randomized clinical trial
Randomized trial of 30 COVID-19 patients in India, comparing povidone-iodine (PVP-I), chlorhexidine gluconate (CHX), and herbal extract mouthwash for reducing SARS-CoV-2 viral load in saliva after a 30 second rinse. All treatments showed ..
Dec 7
2023
 Giulia et al., Journal of Clinical Periodontology, doi:10.1111/jcpe.13905 Eligibility and efficacy of a CPC‐ and CHX‐based antiviral mouthwash for the elimination of SARS‐CoV‐2 from the saliva: A randomized, double‐blind, controlled clinical trial
RCT 20 patients rinsing with CPC-CHX compared with 20 patients rinsing with water, showing no significant difference in short-term viral load via PCR and ELISA. Results are not clear. Figure 3 shows an increase in ELISA I/T between all ti..
Nov 30
2023
 Brookes et al., International Dental Journal, doi:10.1016/j.identj.2023.08.010 Mouthwash Effects on the Oral Microbiome: Are They Good, Bad, or Balanced?
Review of the effects of commonly used mouthwashes on the oral microbiome, which includes bacteria, viruses, bacteriophages, and fungi. While certain mouthwashes have proven antimicrobial actions and clinical effectiveness, more recent me..
Nov 21
2023
 Jing et al., QJM: An International Journal of Medicine, doi:10.1093/qjmed/hcad262 Effective early strategy to prevent olfactory and gustatory dysfunction in COVID-19: a randomized controlled trial
79% lower progression (p<0.0001) and 97% lower severe cases (p<0.0001). RCT 379 mild COVID-19 cases showing significantly lower prevalence and severity of olfactory and gustatory dysfunction with budesonide nasal spray, chlorhexidine mouthwash, and saline nasal irrigation. The control group received no interv..
Oct 11
2023
 Sbricoli et al., Japanese Dental Science Review, doi:10.1016/j.jdsr.2023.09.003 Efficacy of different mouthwashes against COVID-19: A systematic review and network meta-analysis
Systematic review and network meta-analysis evaluating the effectiveness of antiseptic mouthwashes in reducing SARS-CoV-2 viral load in saliva based on data from 14 randomized clinical trials and 21 in vitro studies. The study found that ..
Oct 11
2023
 Zhang et al., BMC Infectious Diseases, doi:10.1186/s12879-023-08669-z Efficacy of mouthwash on reducing salivary SARS-CoV-2 viral load and clinical symptoms: a systematic review and meta-analysis
Systematic review and meta-analysis of 13 randomized controlled trials with a total of 832 participants analyzing the efficacy of mouthwash on reducing salivary SARS-CoV-2 viral load and clinical symptoms in COVID-19 patients. Authors fou..
Jun 12
2023
 Ting et al., Biomedicines, doi:10.3390/biomedicines11061694 Preprocedural Viral Load Effects of Oral Antiseptics on SARS-CoV-2 in Patients with COVID-19: A Systematic Review
Systematic review of 14 RCTs, showing significant reductions in short-term viral load with mouth rinses cetylpyridinium chloride, β-cyclodextrin and citrox, hydrogen peroxide, chlorhexidine, povidone-iodine, hypochlorous acid, saline, and..
Mar 21
2023
 Bonn et al., Journal of Dental Research, doi:10.1177/00220345231156415 Efficacy of a Mouthwash Containing CHX and CPC in SARS-CoV-2–Positive Patients: A Randomized Controlled Clinical Trial
85% improved viral clearance (p=0.2). RCT 61 COVID+ patients showing improved reduction in viral infectivity with a mouthwash containing 0.05% cetylpyridinium chloride (CPC) and 0.05% chlorhexidine digluconate (CHX), compared to 0.9% NaCl. The study only analyzes short-term c..
Sep 8
2022
 Hasan et al., European Journal of Dentistry, doi:10.1055/s-0042-1753470 Effects of Chlorhexidine and Povidone-Iodine on the SARS-CoV-2 Load: A Systematic Review and Meta-analysis
Systematic review and meta analysis showing significantly improved viral clearance with both povidone-iodine and chlorhexidine.
Jul 31
2022
 Ting et al., International Journal of Translational Medicine, doi:10.3390/ijtm2030030 The In Vitro Virucidal Effects of Mouthwashes on SARS-CoV-2
Review of in vitro studies of mouthwashes, showing antiviral activity for SARS-CoV-2 with many compounds including PVP-I, cetylpyridinium chloride, chlorohexidine gluconate, dequalinium chloride, benzalkonium chloride, anionic phthalocyan..
Jul 29
2022
 Natto et al., Medicine, doi:10.1097/MD.0000000000028925 The short-term effect of different chlorhexidine forms versus povidone iodine mouth rinse in minimizing the oral SARS-CoV-2 viral load: An open label randomized controlled clinical trial study
60 patient RCT comparing chlorhexidine, PVP-I, and saline in Saudi Arabia with a single mouth rinse treatment and PCR testing 5 minutes later, showing statistically significant improvement in Ct value for PVP-I. PVP-I showed greater impro..
Jul 28
2022
 Fantozzi et al., American Journal of Otolaryngology, doi:10.1016/j.amjoto.2022.103549 Efficacy of antiseptic mouthrinses against SARS-CoV-2: A prospective randomized placebo-controlled pilot study
Mouthrinse RCT in Italy comparing short-term viral load after a single 60 second treatment with povidone-iodine, hydrogen peroxide, chlorhexidine, and saline. The greatest efficacy was seen with povidone-iodine, especially for patients wi..
Jul 21
2022
 Ghasemi et al., Eur. J. Gen. Dent., doi:10.1055/s-0042-1747958 Reduction in SARS-CoV-2 Oral Viral Load with Prophylactic Mouth Rinse
RCT 116 patients in Iran, showing lower short term viral load with mouth rinses chlorhexidine, hydrogen peroxide, and povidone-iodine. Chlorhexidine and hydrogen peroxide were the most effective.
Jun 30
2022
 Keating et al., NCT04478019 SHIELD Study: Using Naso-oropharyngeal Antiseptic Decolonization to Reduce COVID-19 Viral Shedding (SHIELD)
245 participant chlorhexidine + PVP-I prophylaxis RCT with results not reported over 4 years after completion.
Feb 28
2022
 Xie et al., NCT04931004 Oral Rinse to Reduced Expelled Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) During COVID-19 Infection
Estimated 90 patient chlorhexidine early treatment RCT with results not reported over 4 years after estimated completion.
Jan 28
2022
 Akash et al., Frontiers in Drug Delivery, doi:10.3389/fddev.2023.1164671 (date from preprint) On a model-based approach to improve intranasal spray targeting for respiratory viral infections
Computational fluid dynamics study of nasal spray administration in 2 subjects showing 100x improvement in nasopharyngeal drug delivery using a new spray placement protocol. The study also found the optimal droplet size range for nasophar..
Jan 8
2022
 Mira et al., NCT05543603 Evaluation of the Efficacy of Mouth Rinses With Commercial Mouthwashes to Decrease Viral Load in Saliva in COVID-19 Patients
48 patient chlorhexidine early treatment RCT with results not reported over 4 years after completion.
Dec 11
2021
 Costa et al., Oral Diseases, doi:10.1111/odi.14086 Chlorhexidine mouthwash reduces the salivary viral load of SARS‐CoV‐2: A randomized clinical trial
69% improved viral clearance (p=0.04). RCT 100 outpatients in Brazil showing a reduction in salivary viral load with 0.12% chlorhexidine gluconate mouthwash. The test group gargled and rinsed with 15ml of the mouthwash for 1 minute, while the control group used a placebo. Sali..
Apr 30
2021
 Huang et al., Journal of Medical Virology, doi:10.1002/jmv.26954 Use of chlorhexidine to eradicate oropharyngeal SARS‐CoV‐2 in COVID‐19 patients
75% improved viral clearance (p<0.0001). RCT 294 hospitalized patients in the USA, showing faster oropharyngeal viral clearance with chlorhexidine. Results were better with a combination of oropharyngeal rinse and posterior oropharyngeal spray compared with the rinse alone.
Mar 17
2021
 Elzein et al., Journal of Evidence Based Dental Practice, doi:10.1016/j.jebdp.2021.101584 (date from preprint) In vivo evaluation of the virucidal efficacy of chlorhexidine and povidone-iodine mouthwashes against salivary SARS-CoV-2. A randomized-controlled clinical trial
Small RCT comparing mouthwashing with PVP-I, chlorhexidine, and water, showing significant efficacy for both PVP-I and chlorhexidine, with PVP-I increasing Ct by a mean of 4.45 (p < 0.0001) and chlorhexidine by a mean of 5.69 (p < 0.0001)..
Mar 1
2021
 Jayaraman et al., medRxiv, doi:10.1101/2021.02.25.21252488 Povidone iodine, hydrogen peroxide and chlorhexidine mouthwashes reduce SARS-CoV2 burden in whole mouth fluid and respiratory droplets
Study of SARS-CoV-2 burden in whole mouth fluid and respiratory droplets with povidone iodine, hydrogen peroxide, and chlorhexidine mouthwashes in 36 hospitalized COVID-19 patients using PCR and rapid antigen testing. There were significa..
Dec 14
2020
 Seneviratne et al., Infection, doi:10.1007/s15010-020-01563-9 Efficacy of commercial mouth-rinses on SARS-CoV-2 viral load in saliva: randomized control trial in Singapore
Small mouthwash RCT with 4 PVP-I patients and 2 water patients concluding that PVP-I may have a sustained effect on reducing the salivary SARS-CoV-2 level in COVID-19 patients. ISRCTN95933274.