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All Studies   Meta Analysis    Recent:   

Reduction in SARS-CoV-2 Oral Viral Load with Prophylactic Mouth Rinse

Ghasemi et al., Eur. J. Gen. Dent., doi:10.1055/s-0042-1747958, NCT04719208
Jul 2022  
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PVP-I for COVID-19
12th treatment shown to reduce risk in February 2021
 
*, now known with p = 0.000000004 from 21 studies.
Lower risk for mortality, cases, and viral clearance.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,200+ studies for 70+ treatments. c19early.org
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.
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.
Study covers hydrogen peroxide, chlorhexidine, and povidone-iodine.
Ghasemi et al., 21 Jul 2022, Randomized Controlled Trial, Iran, peer-reviewed, 22 authors, trial NCT04719208 (history).
This PaperPovidone-Iod..All
{ 'indexed': {'date-parts': [[2024, 5, 1]], 'date-time': '2024-05-01T14:32:42Z', 'timestamp': 1714573962284}, 'reference-count': 27, 'publisher': 'Georg Thieme Verlag KG', 'issue': '02', 'license': [ { 'start': { 'date-parts': [[2022, 7, 21]], 'date-time': '2022-07-21T00:00:00Z', 'timestamp': 1658361600000}, 'content-version': 'vor', 'delay-in-days': 81, 'URL': 'https://creativecommons.org/licenses/by/4.0/'}], 'content-domain': {'domain': [], 'crossmark-restriction': False}, 'published-print': {'date-parts': [[2022, 5]]}, 'abstract': '<jats:title>Abstract</jats:title><jats:p>\n' ' Objectives\u2003The medical and health facilities are at high risk of severe acute ' 'respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This study tested the ' 'preprocedural prophylactic mouthwash rinses to reduce the oral viral load. The findings from ' 'this study will help the practitioners to select the best mouthwash for the patients to ' 'mitigate the risk of transmission during aerosolizing. This study aimed to evaluate the ' 'effectiveness of four commonly used types of mouthwash in reducing intraoral viral load among ' 'hospitalized coronavirus disease 2019 patients.</jats:p><jats:p>\n' ' Materials and Methods\u2003This prospective cohort study was conducted with 116 ' 'patients referred to the Masih Daneshvari Hospital in Tehran, Hamadan University of Medical ' 'Sciences of Hamadan City, and Mashhad University of Medical Sciences. Patients were ' 'randomized into four groups with each group rinsed their mouth with 20\u2009mL of 2% ' 'povidone-iodine, 1% hydrogen peroxide, normal saline as a control study group, or 0.12% ' 'chlorhexidine, respectively, for 20\u2009seconds. The standard reverse transcription ' 'polymerase chain reaction method evaluated the virus load before and at 1\u2009hour, 2\u2009' 'hours, and 4\u2009hours after using the mentioned mouthwash.</jats:p><jats:p>\n' ' Results\u2003Our results revealed that chlorhexidine and H2O2 showed the highest ' 'efficiency in reducing SARS-Co-2 load in the oral cavity and nasopharyngeal region of ' 'patients; they increased the Ct values by 9 to 10 (before: 25.84 vs. after 32. 4, p\u2009' '&lt;\u20090.455) (17.333 vs. after 26.497, p &lt;0.097).</jats:p><jats:p>\n' ' Conclusion\u2003Our findings suggest that chlorhexidine and H2O2 could be used in ' 'dental clinics to reduce the risk of transmitting the SARS-CoV-2 virus from infected ' 'individuals to dentists before dental procedures.</jats:p>', 'DOI': '10.1055/s-0042-1747958', 'type': 'journal-article', 'created': {'date-parts': [[2022, 7, 21]], 'date-time': '2022-07-21T22:52:32Z', 'timestamp': 1658443952000}, 'page': '094-101', 'source': 'Crossref', 'is-referenced-by-count': 2, 'title': 'Reduction in SARS-CoV-2 Oral Viral Load with Prophylactic Mouth Rinse', 'prefix': '10.1055', 'volume': '11', 'author': [ { 'given': 'Shohreh', 'family': 'Ghasemi', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Oral and Maxillofacial Surgery, The Dental College ' 'of Georgia, Augusta University, Augusta, Georgia, USA'}]}, { 'given': 'Seyed Alireza', 'family': 'Nadji', 'sequence': 'additional', 'affiliation': [ { 'name': 'Virology Research Center, National Research Institute of ' 'Tuberculosis and Lung Diseases, Shahid Beheshti University of ' 'Medical Sciences, Tehran, Iran'}]}, { 'given': 'Ali', 'family': 'Heidari', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Oral and Maxillofacial Surgery, School of ' 'Dentistry, Hamadan University of Medical Sciences, Hamadan, ' 'Iran'}]}, { 'given': 'Jeffrey N.', 'family': 'James', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Oral and Maxillofacial Surgery, The Dental College ' 'of Georgia, Augusta University, Augusta, Georgia, USA'}]}, { 'given': 'Mahboobeh', 'family': 'Karimi-Galougahi', 'sequence': 'additional', 'affiliation': [ { 'name': 'Virology Research Center, National Research Institute of ' 'Tuberculosis and Lung Diseases, Shahid Beheshti University of ' 'Medical Sciences, Tehran, Iran'}]}, { 'given': 'Negar', 'family': 'Raygani', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Otolaryngology, Masih Daneshvari Hospital, Tehran, ' 'Iran'}]}, { 'given': 'Salman', 'family': 'Khazaei', 'sequence': 'additional', 'affiliation': [ { 'name': 'Research Center for Health Sciences, Hamadan University of ' 'Medical Sciences, Hamadan, Iran'}]}, { 'given': 'Freshteh', 'family': 'Mehri', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Oral and Maxillofacial Surgery, School of ' 'Dentistry, Hamadan University of Medical Sciences, Hamadan, ' 'Iran'}]}, { 'given': 'Ali', 'family': 'Poormohammadi', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Oral and Maxillofacial Surgery, School of ' 'Dentistry, Hamadan University of Medical Sciences, Hamadan, ' 'Iran'}]}, { 'given': 'Saeid', 'family': 'Bashirian', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Oral and Maxillofacial Surgery, School of ' 'Dentistry, Hamadan University of Medical Sciences, Hamadan, ' 'Iran'}]}, { 'given': 'Maryam', 'family': 'Mehrpooya', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Oral and Maxillofacial Surgery, School of ' 'Dentistry, Hamadan University of Medical Sciences, Hamadan, ' 'Iran'}]}, { 'given': 'Amirfarhang', 'family': 'Miresmaeili', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Oral and Maxillofacial Surgery, School of ' 'Dentistry, Hamadan University of Medical Sciences, Hamadan, ' 'Iran'}]}, { 'given': 'Farid Azizi', 'family': 'Jalilian', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Oral and Maxillofacial Surgery, School of ' 'Dentistry, Hamadan University of Medical Sciences, Hamadan, ' 'Iran'}]}, { 'given': 'Samaneh', 'family': 'Shirahmadi', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Oral and Maxillofacial Surgery, School of ' 'Dentistry, Hamadan University of Medical Sciences, Hamadan, ' 'Iran'}]}, { 'given': 'Fariba', 'family': 'Keramat', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Oral and Maxillofacial Surgery, School of ' 'Dentistry, Hamadan University of Medical Sciences, Hamadan, ' 'Iran'}]}, { 'given': 'Alireza', 'family': 'Soltanian', 'sequence': 'additional', 'affiliation': [ { 'name': 'Modeling of Noncommunicable Diseases Research Center, Hamadan ' 'University of Medical Sciences, Hamadan, Iran'}]}, { 'given': 'Nastaran', 'family': 'Ansari', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Oral and Maxillofacial Surgery, School of ' 'Dentistry, Hamadan University of Medical Sciences, Hamadan, ' 'Iran'}]}, { 'given': 'Farhad', 'family': 'Zeynalzadeh', 'sequence': 'additional', 'affiliation': [ { 'name': 'PostDoc Position at Department of Oral and Maxillofacial ' 'Surgery, Mashhad University of Medical Sciences, Mashhad, ' 'Iran'}]}, { 'given': 'Amirali', 'family': 'Ebrahimi', 'sequence': 'additional', 'affiliation': [ { 'name': 'Virology Research Center, National Research Institute of ' 'Tuberculosis and Lung Diseases, Shahid Beheshti University of ' 'Medical Sciences, Tehran, Iran'}]}, { 'given': 'Amirreza', 'family': 'Dashti', 'sequence': 'additional', 'affiliation': [ { 'name': 'Nutrition Health Research Center, Health Sciences & Technology ' 'Research Institute, Hamadan University of Medical Sciences, ' 'Hamadan, Iran'}]}, { 'given': 'Ryan F.', 'family': 'Bloomquist', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Restorative Sciences, The Dental College of ' 'Georgia, Augusta University, Augusta, Georgia, USA'}]}, { 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'unspecified', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2022, 11, 2]], 'date-time': '2022-11-02T00:08:21Z', 'timestamp': 1667347701000}, 'score': 1, 'resource': {'primary': {'URL': 'http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-1747958'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2022, 5]]}, 'references-count': 27, 'journal-issue': { 'issue': '02', 'published-online': {'date-parts': [[2022, 11, 1]]}, 'published-print': {'date-parts': [[2022, 5]]}}, 'URL': 'http://dx.doi.org/10.1055/s-0042-1747958', 'relation': {}, 'ISSN': ['2278-9626', '2320-4753'], 'subject': [], 'container-title-short': 'European Journal of General Dentistry', 'published': {'date-parts': [[2022, 5]]}}
Late treatment
is less effective
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