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

DOI record: { "DOI": "10.1007/s00405-024-08518-y", "ISSN": [ "0937-4477", "1434-4726" ], "URL": "http://dx.doi.org/10.1007/s00405-024-08518-y", "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 ≤ 48h. 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 (– 1.6 day, p = 0.0487) with earlier improvement of taste (– 2 days, p = 0.0404). COVID-19 subjects with severe nasal symptoms at D0 showed the earliest resolution of anosmia (– 5.2 days, p = 0.0281), post-nasal drip (– 4.1 days, p = 0.0102), face pain/heaviness (– 4.5 days, p = 0.0078), headache (– 3.1 days, p = 0.0195), sore throat (– 3.3 days, p = 0.0319), dyspnea (– 3.1 days, p = 0.0195), chest congestion (– 2.8 days, p = 0.0386) and loss of appetite (– 4.5 days, p = 0.0186) with nasal wash. In URTIs subjects, an earlier resolution of rhinorrhea (– 3.5 days, p = 0.0370), post-nasal drip (– 3.7 days, p = 0.0378), and overall sickness (– 4.3 days, p = 0.0248) 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 (≥ 1.5log10 copies/10000 cells at Day 5: 88.9% vs 62.5%, p = 0.0456). 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 = 0.0413).</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>", "alternative-id": [ "8518" ], "assertion": [ { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "Received", "name": "received", "order": 1, "value": "30 November 2023" }, { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "Accepted", "name": "accepted", "order": 2, "value": "29 January 2024" }, { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "First Online", "name": "first_online", "order": 3, "value": "20 February 2024" }, { "group": { "label": "Declarations", "name": "EthicsHeading" }, "name": "Ethics", "order": 1 }, { "group": { "label": "Conflict of interest", "name": "EthicsHeading" }, "name": "Ethics", "order": 2, "value": "LG and SV and CR-S were scientific advisors for the study and therefore received fees from Laboratoire de la Mer." }, { "group": { "label": "Employment", "name": "EthicsHeading" }, "name": "Ethics", "order": 3, "value": "GN is employee of Laboratoire de la Mer." } ], "author": [ { "ORCID": "http://orcid.org/0000-0003-0113-6121", "affiliation": [], "authenticated-orcid": false, "family": "de Gabory", "given": "Ludovic", "sequence": "first" }, { "affiliation": [], "family": "Vallet", "given": "Sophie", "sequence": "additional" }, { "affiliation": [], "family": "Naelten", "given": "Gaëlle", "sequence": "additional" }, { "affiliation": [], "family": "Raherison-Semjen", "given": "Chantal", "sequence": "additional" } ], "clinical-trial-number": [ { "clinical-trial-number": "nct04916639", "registry": "10.18810/clinical-trials-gov" } ], "container-title": "European Archives of Oto-Rhino-Laryngology", "container-title-short": "Eur Arch Otorhinolaryngol", "content-domain": { "crossmark-restriction": false, "domain": [ "link.springer.com" ] }, "created": { "date-parts": [ [ 2024, 2, 20 ] ], "date-time": "2024-02-20T14:02:45Z", "timestamp": 1708437765000 }, "deposited": { "date-parts": [ [ 2024, 2, 20 ] ], "date-time": "2024-02-20T14:06:16Z", "timestamp": 1708437976000 }, "funder": [ { "name": "Laboratoire de la Mer" } ], "indexed": { "date-parts": [ [ 2024, 2, 21 ] ], "date-time": "2024-02-21T00:24:49Z", "timestamp": 1708475089066 }, "is-referenced-by-count": 0, "issued": { "date-parts": [ [ 2024, 2, 20 ] ] }, "language": "en", "license": [ { "URL": "https://creativecommons.org/licenses/by/4.0", "content-version": "tdm", "delay-in-days": 0, "start": { "date-parts": [ [ 2024, 2, 20 ] ], "date-time": "2024-02-20T00:00:00Z", "timestamp": 1708387200000 } }, { "URL": "https://creativecommons.org/licenses/by/4.0", "content-version": "vor", "delay-in-days": 0, "start": { "date-parts": [ [ 2024, 2, 20 ] ], "date-time": "2024-02-20T00:00:00Z", "timestamp": 1708387200000 } } ], "link": [ { "URL": "https://link.springer.com/content/pdf/10.1007/s00405-024-08518-y.pdf", "content-type": "application/pdf", "content-version": "vor", "intended-application": "text-mining" }, { "URL": "https://link.springer.com/article/10.1007/s00405-024-08518-y/fulltext.html", "content-type": "text/html", "content-version": "vor", "intended-application": "text-mining" }, { "URL": "https://link.springer.com/content/pdf/10.1007/s00405-024-08518-y.pdf", "content-type": "application/pdf", "content-version": "vor", "intended-application": "similarity-checking" } ], "member": "297", "original-title": [], "prefix": "10.1007", "published": { "date-parts": [ [ 2024, 2, 20 ] ] }, "published-online": { "date-parts": [ [ 2024, 2, 20 ] ] }, "publisher": "Springer Science and Business Media LLC", "reference": [ { "DOI": "10.1016/S1473-3099(05)70270-X", "author": "R Eccles", "doi-asserted-by": "publisher", "first-page": "718", "journal-title": "Lancet Infect Dis", "key": "8518_CR1", "unstructured": "Eccles R (2005) Understanding the symptoms of the common cold and influenza. 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