Beneficial effects of a mouthwash containing an antiviral phthalocyanine derivative on the length of hospital stay for COVID-19: randomised trial

{ 'indexed': {'date-parts': [[2022, 5, 20]], 'date-time': '2022-05-20T05:11:35Z', 'timestamp': 1653023495119}, 'reference-count': 39, 'publisher': 'Springer Science and Business Media LLC', 'issue': '1', 'license': [ { 'start': { 'date-parts': [[2021, 10, 7]], 'date-time': '2021-10-07T00:00:00Z', 'timestamp': 1633564800000}, 'content-version': 'tdm', 'delay-in-days': 0, 'URL': 'https://creativecommons.org/licenses/by/4.0'}, { 'start': { 'date-parts': [[2021, 10, 7]], 'date-time': '2021-10-07T00:00:00Z', 'timestamp': 1633564800000}, 'content-version': 'vor', 'delay-in-days': 0, 'URL': 'https://creativecommons.org/licenses/by/4.0'}], 'content-domain': {'domain': ['link.springer.com'], 'crossmark-restriction': False}, 'published-print': {'date-parts': [[2021, 12]]}, 'abstract': '<jats:title>Abstract</jats:title><jats:p>The risk of contamination and dissemination by ' 'SARS-CoV-2 has a strong link with nasal, oral and pharyngeal cavities. Recently, our research ' 'group observed the promising performance of an anionic phthalocyanine derivative (APD) used ' 'in a mouthwash protocol without photoexcitation; this protocol improved the general clinical ' 'condition of patients infected with SARS-CoV-2. The present two-arm study evaluated in vitro ' 'the antiviral activity and cytotoxicity of APD. Additionally, a triple-blind randomized ' 'controlled trial was conducted with 41 hospitalized patients who tested positive for ' 'COVID-19. All the included patients received World Health Organization standard care hospital ' 'treatment (non-intensive care) plus active mouthwash (experimental group AM/n\u2009=\u200920) ' 'or nonactive mouthwash (control group NAM/n\u2009=\u200921). The adjunct mouthwash ' 'intervention protocol used in both groups consisted one-minute gargling/rinsing / 5 times/day ' 'until hospital discharge. Groups were compared considering age, number of comorbidities, ' 'duration of symptoms prior admission and length of hospital stay (LOS). The associations ' 'between group and sex, age range, presence of comorbidities, admission to Intensive care unit ' '(ICU) and death were also evaluated. The in vitro evaluation demonstrated that APD compound ' 'was highly effective for reduction of SARS-CoV-2 viral load in the 1.0\xa0mg/mL (99.96%) to ' '0.125\xa0mg/mL (92.65%) range without causing cytotoxicity. Regarding the clinical trial, the ' 'median LOS of the AM group was significantly shortened (4\xa0days) compared with that of the ' 'NAM group (7\xa0days) (p\u2009=\u20090.0314). Additionally, gargling/rinsing with APD was ' 'very helpful in reducing the severity of symptoms (no ICU care was needed) compared to not ' 'gargling/rinsing with APD (28.6% of the patients in the NAM group needed ICU care, and 50% of ' 'this ICU subgroup passed way, p\u2009=\u20090.0207). This study indicated that the mechanical ' 'action of the protocol involving mouthwash containing a compound with antiviral effects ' 'against SARS-CoV-2 may reduce the symptoms of the patients and the spread of infection. The ' 'use of APD in a mouthwash as an adjuvant the hospital COVID-19 treatment presented no ' 'contraindication and reduced the hospital stay period.</jats:p><jats:p><jats:bold>Trial ' 'registration:</jats:bold> The clinical study was registered at REBEC—Brazilian Clinical Trial ' 'Register (RBR-58ftdj).</jats:p>', 'DOI': '10.1038/s41598-021-99013-5', 'type': 'journal-article', 'created': {'date-parts': [[2021, 10, 7]], 'date-time': '2021-10-07T10:25:59Z', 'timestamp': 1633602359000}, 'update-policy': 'http://dx.doi.org/10.1007/springer_crossmark_policy', 'source': 'Crossref', 'is-referenced-by-count': 5, 'title': 'Beneficial effects of a mouthwash containing an antiviral phthalocyanine derivative on the ' 'length of hospital stay for COVID-19: randomised trial', 'prefix': '10.1038', 'volume': '11', 'author': [ {'given': 'Paulo Sérgio', 'family': 'da Silva Santos', 'sequence': 'first', 'affiliation': []}, { 'given': 'Bernardo', 'family': 'da Fonseca Orcina', 'sequence': 'additional', 'affiliation': []}, { 'given': 'Rafael Rahal Guaragna', 'family': 'Machado', 'sequence': 'additional', 'affiliation': []}, {'given': 'Fabiano Vieira', 'family': 'Vilhena', 'sequence': 'additional', 'affiliation': []}, { 'given': 'Lucas Marques', 'family': 'da Costa Alves', 'sequence': 'additional', 'affiliation': []}, { 'given': 'Mariana Schutzer Ragghianti', 'family': 'Zangrando', 'sequence': 'additional', 'affiliation': []}, { 'given': 'Rodrigo Cardoso', 'family': 'de Oliveira', 'sequence': 'additional', 'affiliation': []}, { 'given': 'Mariana Quirino Silveira', 'family': 'Soares', 'sequence': 'additional', 'affiliation': []}, {'given': 'Andréa Name Colado', 'family': 'Simão', 'sequence': 'additional', 'affiliation': []}, { 'given': 'Emilene Cristine Izu Nakamura', 'family': 'Pietro', 'sequence': 'additional', 'affiliation': []}, { 'given': 'Juliana Pescinelli Garcia', 'family': 'Kuroda', 'sequence': 'additional', 'affiliation': []}, { 'given': 'Ivanilda Aparecida', 'family': 'de Almeida Benjamim', 'sequence': 'additional', 'affiliation': []}, {'given': 'Danielle Bastos', 'family': 'Araujo', 'sequence': 'additional', 'affiliation': []}, {'given': 'Sérgio Hiroshi', 'family': 'Toma', 'sequence': 'additional', 'affiliation': []}, {'given': 'Lourival', 'family': 'Flor', 'sequence': 'additional', 'affiliation': []}, {'given': 'Koiti', 'family': 'Araki', 'sequence': 'additional', 'affiliation': []}, {'given': 'Edison Luiz', 'family': 'Durigon', 'sequence': 'additional', 'affiliation': []}], 'member': '297', 'published-online': {'date-parts': [[2021, 10, 7]]}, 'reference': [ { 'key': '99013_CR1', 'first-page': '10229', 'volume': '395', 'author': 'F Zhou', 'year': '2020', 'unstructured': 'Zhou, F. et al. 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