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All Studies   Meta Analysis    Recent:   

Chlorhexidine mouthwash reduces the salivary viral load of SARS‐CoV‐2: A randomized clinical trial

Costa et al., Oral Diseases, doi:10.1111/odi.14086
Dec 2021  
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Viral load, 60 min 69% Improvement Relative Risk Chlorhexidine  Costa et al.  LATE TREATMENT  DB RCT Does late treatment with chlorhexidine reduce short-term viral load? Double-blind RCT 100 patients in Brazil Improved viral clearance with chlorhexidine (p=0.045) c19early.org Costa et al., Oral Diseases, December 2021 Favorschlorhexidine Favorscontrol 0 0.5 1 1.5 2+
45th treatment shown to reduce risk in January 2024
 
*, now with p = 0.00000000062 from 3 studies.
Lower risk for progression, cases, and viral clearance.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,300+ studies for 77 treatments. c19early.org
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. Saliva samples were collected at baseline, 5 minutes, and 60 minutes after using the mouthwash. The reduction in viral load was significantly greater in the test group at 5 and 60 minutes compared to the control group.
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 Tarragó‐Gil, Alemany 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 that can differentiate intact vs. degraded virus are preferred.
This study is excluded in the after exclusion results of meta analysis: study only provides short-term viral load results.
viral load, 69.0% lower, relative load 0.31, p = 0.04, treatment mean 2.45 (±3.88) n=50, control mean 0.76 (±4.41) n=50, 60 minutes.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Costa et al., 11 Dec 2021, Double Blind Randomized Controlled Trial, placebo-controlled, Brazil, peer-reviewed, 6 authors.
This PaperChlorhexidineAll
Chlorhexidine mouthwash reduces the salivary viral load of SARS‐CoV‐2: A randomized clinical trial
Denis Damião Costa, Carlos Brites, Sara Nunes Vaz, Daniele Souza De Santana, Jean Nunes Dos Santos, Patricia Ramos Cury
Oral Diseases, doi:10.1111/odi.14086
Objectives: This study aimed to evaluate the effect of 0.12% chlorhexidine gluconate on the salivary load of SARS-CoV-2. Materials and Methods: A randomized, double-blind, placebo-controlled trial was performed on 100 participants positive for SARS-CoV-2. In the test group (n = 50), volunteers gargled with a mouthwash containing 15 ml of 0.12% chlorhexidine gluconate for 1 min, while the control group (n = 50) used a placebo. Saliva samples were obtained before (baseline) and 5 and 60 min after using the solutions. Real-time reverse transcription polymerase chain reaction assays (qRT-PCR) were carried out and the cycle threshold (Ct) was computed. The chi-square test and t-test were used for group comparison (p ≤ 0.05). Results: The differences in Ct values between the 5-min evaluation and baseline (test group: 2.19 ± 4.30; control: -0.40 ± 3.87, p = 0.002) and between 60 min and baseline (test group: 2.45 ± 3.88; control: 0.76 ± 4.41, p = 0.05) were significantly greater in the test group, revealing a reduction of viral load. Furthermore, there was a reduction in the load of SARS-CoV-2 in 72% of the volunteers using chlorhexidine versus 30% in the control group (p = 0.001). Conclusions: Chlorhexidine gluconate (0.12%) was effective in reducing salivary SARS-CoV-2 load for at least 60 min.
TA B L E 4 Association between SARS-CoV-2 salivary viral load reduction from baseline and demographic data, cigarette smoking, health status and COVID-19 symptoms (N = 100) PATI E NT CO N S E NT S TATE M E NT Participants signed the consent form. PE R M I SS I O N TO R E PRO D U CE M ATE R I A L FRO M OTH E R S O U RCE S There is no material from other sources. CLI N I C A L TR I A L R EG I S TR ATI O N It was registered on clinicaltrial.gov.br on 03/17/2021, protocol UTN U1111-1264-8920. PE E R R E V I E W The peer review history for this article is available at https://publo ns.com/publo n/10.1111/odi.14086.
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Late treatment
is less effective
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