Apr 28 |
Chlorhexidine reduces COVID-19 risk: real-time meta analysis of 3 studies | |
| Significantly lower risk is seen for progression, cases, and viral clearance. 3 studies from 3 independent teams in 3 countries show significant benefit. Meta analysis using the most serious outcome reported shows 79% [66‑87%] .. | ||
Dec 9 2024 |
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 |
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 |
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 |
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 |
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 |
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 |
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 |
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 |
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 |
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 |
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 |
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 |
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.. | ||
Sep 8 2022 |
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 |
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, and anionic phthalo.. | ||
Jul 29 2022 |
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 |
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 |
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 |
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 2 years after completion. | ||
Feb 28 2022 |
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 3 years after estimated completion. | ||
Jan 28 2022 |
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 |
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 3 years after completion. | ||
Dec 11 2021 |
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.. | ||
Oct 20 2021 |
et al., NCT04584684 | Mouth Rinses for Inactivation of COVID-19 (MOR) |
| 129 patient chlorhexidine early treatment RCT with results not reported over 3 years after completion. | ||
Apr 30 2021 |
et al., Journal of Medical Virology, doi:10.1002/jmv.26954 | Use of chlorhexidine to eradicate oropharyngeal SARS‐CoV‐2 in COVID‐19 patients |
| 85% 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 |
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 |
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 |
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. | ||
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. IMA and WCH
provide treatment protocols.
Thanks for your feedback! Please search before submitting papers and note
that studies are listed under the date they were first available, which may be
the date of an earlier preprint.