Seawater nasal wash to reduce symptom duration and viral load in COVID-19 and upper respiratory tract infections: a randomized controlled multicenter trial

{ 'indexed': {'date-parts': [[2024, 2, 21]], 'date-time': '2024-02-21T00:24:49Z', 'timestamp': 1708475089066}, 'reference-count': 50, 'publisher': 'Springer Science and Business Media LLC', 'license': [ { 'start': { 'date-parts': [[2024, 2, 20]], 'date-time': '2024-02-20T00:00:00Z', 'timestamp': 1708387200000}, 'content-version': 'tdm', 'delay-in-days': 0, 'URL': 'https://creativecommons.org/licenses/by/4.0'}, { 'start': { 'date-parts': [[2024, 2, 20]], 'date-time': '2024-02-20T00:00:00Z', 'timestamp': 1708387200000}, 'content-version': 'vor', 'delay-in-days': 0, 'URL': 'https://creativecommons.org/licenses/by/4.0'}], 'funder': [{'name': 'Laboratoire de la Mer'}], 'content-domain': {'domain': ['link.springer.com'], 'crossmark-restriction': False}, 'abstract': '<jats:title>Abstract</jats:title><jats:sec>\n' ' <jats:title>Purpose</jats:title>\n' ' <jats:p>The objective was to assess the efficacy of seawater nasal wash on ' 'symptom duration, intranasal viral load, household transmission in COVID-19 and ' 'URTIs.</jats:p>\n' ' </jats:sec><jats:sec>\n' ' <jats:title>Methods</jats:title>\n' ' <jats:p>This prospective, randomized, controlled, multicentric, parallel study ' 'included 355 mild/moderate COVID-19 and URTI adults with rhinologic symptoms\u2009≤\u200948h. ' 'Active group performed 4-daily nasal washes with undiluted isotonic seawater versus control ' 'group (without nasal wash). Symptoms were self-assessed daily using the WURSS-21 ' 'questionnaire for 3 weeks. Viral load was measured by RT-PCR on nasopharyngeal swabs ' 'collected on Day 0, Day 5, Day 14 and Day 21. Digital droplet PCR was additionally performed ' 'for SARS-CoV-2.</jats:p>\n' ' </jats:sec><jats:sec>\n' ' <jats:title>Results</jats:title>\n' ' <jats:p>Overall COVID-19 subjects recovered earlier the ability to accomplish ' 'daily activities in the active group (–\xa01.6 day, p\u2009=\u20090.0487) with earlier ' 'improvement of taste (–\xa02 days, p\u2009=\u20090.0404). COVID-19 subjects with severe nasal ' 'symptoms at D0 showed the earliest resolution of anosmia (– 5.2 days, p\u2009=\u20090.0281), ' 'post-nasal drip (– 4.1 days, p\u2009=\u20090.0102), face pain/heaviness (– 4.5 days, p\u2009' '=\u20090.0078), headache (– 3.1 days, p\u2009=\u20090.0195), sore throat (– 3.3 days, p\u2009' '=\u20090.0319), dyspnea (– 3.1 days, p\u2009=\u20090.0195), chest congestion (– 2.8 days, ' 'p\u2009=\u20090.0386) and loss of appetite (– 4.5 days, p\u2009=\u20090.0186) with nasal ' 'wash. In URTIs subjects, an earlier resolution of rhinorrhea (– 3.5 days, p\u2009=\u2009' '0.0370), post-nasal drip (– 3.7 days, p\u2009=\u20090.0378), and overall sickness (– 4.3 ' 'days, p\u2009=\u20090.0248) was reported with nasal wash.</jats:p>\n' ' <jats:p>Evolution towards more severe COVID-19 was lower in active vs control, ' 'with earlier viral load reduction in youngest subjects (≥\u20091.5log10 copies/10000 cells at ' 'Day 5: 88.9% vs 62.5%, p\u2009=\u20090.0456). In the active group, a lower percentage of ' 'SARS-CoV-2 positive household contacts (0–10.7%) was reported vs controls (3.2–16.1%) among ' 'subjects with Delta variant (p\u2009=\u20090.0413).</jats:p>\n' ' </jats:sec><jats:sec>\n' ' <jats:title>Conclusion</jats:title>\n' ' <jats:p>This trial showed the efficacy and safety of seawater nasal wash in ' 'COVID-19 and URTIs.</jats:p>\n' ' </jats:sec><jats:sec>\n' ' <jats:title>Trial registration</jats:title>\n' ' <jats:p>Trial registry ClinicalTrials.gov: NCT04916639. Registration date: ' '04.06.2021.</jats:p>\n' ' </jats:sec>', 'DOI': '10.1007/s00405-024-08518-y', 'type': 'journal-article', 'created': {'date-parts': [[2024, 2, 20]], 'date-time': '2024-02-20T14:02:45Z', 'timestamp': 1708437765000}, 'update-policy': 'http://dx.doi.org/10.1007/springer_crossmark_policy', 'source': 'Crossref', 'is-referenced-by-count': 0, 'title': 'Seawater nasal wash to reduce symptom duration and viral load in COVID-19 and upper respiratory ' 'tract infections: a randomized controlled multicenter trial', 'prefix': '10.1007', 'clinical-trial-number': [ { 'clinical-trial-number': 'nct04916639', 'registry': '10.18810/clinical-trials-gov'}], 'author': [ { 'ORCID': 'http://orcid.org/0000-0003-0113-6121', 'authenticated-orcid': False, 'given': 'Ludovic', 'family': 'de Gabory', 'sequence': 'first', 'affiliation': []}, {'given': 'Sophie', 'family': 'Vallet', 'sequence': 'additional', 'affiliation': []}, {'given': 'Gaëlle', 'family': 'Naelten', 'sequence': 'additional', 'affiliation': []}, { 'given': 'Chantal', 'family': 'Raherison-Semjen', 'sequence': 'additional', 'affiliation': []}], 'member': '297', 'published-online': {'date-parts': [[2024, 2, 20]]}, 'reference': [ { 'key': '8518_CR1', 'doi-asserted-by': 'publisher', 'first-page': '718', 'DOI': '10.1016/S1473-3099(05)70270-X', 'volume': '5', 'author': 'R Eccles', 'year': '2005', 'unstructured': 'Eccles R (2005) Understanding the symptoms of the common cold and ' 'influenza. 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