PVP-I for COVID-19
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Protocols combine treatments.
In vitro study showing undiluted PVP-I (1% w/v) achieved >5 log10 reduction in SARS-CoV-2 virus titres at 15, 30 and 60 seconds treatment exposure under both clean and dirty conditions. In contrast, when PVP-I was tested at 1:2 dilution a >4 log10 kill at 15 seconds and >5 log10 kill at 30 and 60 seconds in comparison to control was seen in both clean and dirty conditions.
10 preclinical studies support the efficacy of povidone-iodine for COVID-19:
1.
Hup et al., Efficacy of Mouthwashes Delivered via Dental Unit Waterlines in Reducing Aerosolized Surrogate SARS-CoV-2, Medical Science Monitor, doi:10.12659/MSM.950753.
2.
Xu et al., Differential Effects of Antiseptic Mouth Rinses on SARS-CoV-2 Infectivity In Vitro, Pathogens, doi:10.3390/pathogens10030272.
3.
Tucker et al., In vitro inactivation of SARS-CoV-2 with 0.5% povidone iodine nasal spray (Nasodine) at clinically relevant concentrations and timeframes using tissue culture and PCR based assays, bioRxiv, doi:10.1101/2021.01.31.426979.
4.
Pelletier et al., Efficacy of Povidone-Iodine Nasal and Oral Antiseptic Preparations Against Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV-2), Ear, Nose & Throat Journal, doi:10.1177/0145561320957237.
5.
Frank et al., In Vitro Efficacy of a Povidone-Iodine Nasal Antiseptic for Rapid Inactivation of SARS-CoV-2, JAMA Otolaryngol Head Neck Surg, doi:10.1001/jamaoto.2020.3053.
6.
Meister et al., Virucidal Efficacy of Different Oral Rinses Against Severe Acute Respiratory Syndrome Coronavirus 2, The Journal of Infectious Diseases, doi:10.1093/infdis/jiaa471.
7.
Anderson et al., Povidone-Iodine Demonstrates Rapid In Vitro Virucidal Activity Against SARS-CoV-2, The Virus Causing COVID-19 Disease, Infectious Diseases and Therapy, doi:10.1007/s40121-020-00316-3.
8.
Hassandarvish et al., Povidone iodine gargle and mouthwash, British Dental Journal volume, doi:10.1038/s41415-020-1794-1.
Hassandarvish et al., 26 Jun 2020, peer-reviewed, 8 authors.
In vitro studies are an important part of preclinical research, however results may be very different in vivo.
Special care and new environments
British Dental Journal, doi:10.1038/s41415-020-1786-1
30 and 60 seconds treatment exposure under both clean and dirty conditions. In contrast, when PVP-I was tested at 1:2 dilution a >4 log10 kill at 15 seconds and >5 log10 kill at 30 and 60 seconds in comparison to control was seen in both clean and dirty. Dental practice poses a potential risk of COVID-19 cross-infection among patients, dentists and their assistants through direct exposure to saliva and indirect contact through contaminated instruments. 3 Several associations, including the Australian Dental Association, have recommended using a preprocedural mouthwash with products such as povidone iodine. 4 In our study, we present direct evidence of the virucidal activity of PVP-I gargle and against SARS-CoV-2 in just 15 seconds. In today's scenario, PVP-I gargle and mouthwash could be an adjuvant to PPEs in reducing the risk of COVID-19 transmission in healthcare practices, especially when oral interventions are warranted, such as in dental practice.
References
Challacombe, Kirk-Bayley, Sunkaraneni, Combes, Povidone iodine, Br Dent J
Fallahi H R, Keyhan S O, Zandian, Kim, Cheshmi, Being a front-line dentist during the Covid-19 pandemic: a literature review, Maxillofac Plast Reconstr Surg
Janssen, Eickmann, Zorn, In vitro bactericidal and virucidal efficacy of povidone-iodine gargle/mouthwash against respiratory and oral tract pathogens, Infect Dis Ther
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