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Efficacy of Mouth Rinses and Nasal Spray in the Inactivation of SARS-CoV-2: A Systematic Review and Meta-Analysis of In Vitro and In Vivo Studies

Idrees et al., International Journal of Environmental Research and Public Health, doi:10.3390/ijerph191912148
Sep 2022  
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PVP-I for COVID-19
13th treatment shown to reduce risk in February 2021
 
*, now known with p = 0.000000037 from 20 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.
3,900+ studies for 60+ treatments. c19early.org
Systematic review and meta analysis showing significant reduction in SARS-CoV-2 salivary viral load with povidone-iodine and chlorhexidine.
2 meta analyses show significant improvements with povidone-iodine for viral load Hasan, Idrees and viral clearance Hasan.
Currently there are 20 povidone-iodine for COVID-19 studies, showing 72% lower mortality [8‑92%], 76% lower hospitalization [-14‑95%], and 45% fewer cases [20‑62%].
Idrees et al., 25 Sep 2022, peer-reviewed, 6 authors. Contact: omar.kujan@uwa.edu.au (corresponding author).
This PaperPovidone-Iod..All
Efficacy of Mouth Rinses and Nasal Spray in the Inactivation of SARS-CoV-2: A Systematic Review and Meta-Analysis of In Vitro and In Vivo Studies
Majdy Idrees, Bridget Mcgowan, Amr Fawzy, Abdulwahab Ali Abuderman, Ramesh Balasubramaniam, Omar Kujan
International Journal of Environmental Research and Public Health, doi:10.3390/ijerph191912148
Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) is a global and evolving pandemic associated with heavy health and financial burdens. Considering the oral cavity as the major reservoir for SARS-CoV-2, a systematic review and meta-analysis were conducted to assess the efficacy of mouth rinses and nasal sprays in reducing the salivary viral load of SARS-CoV-2. All in vivo and in vitro studies that assessed the virucidal efficacy of mouth rinses and nasal sprays against SARS-CoV-2 and were published in the English language from December 2019 to April 2022 were considered for analyses. Special Medical Subject Headings terms were used to search Pubmed, Scopus, Embase Ovid, and Web of Science databases. The toxicological data reliability assessment tool (ToxRToool) was used to assess the quality of the included studies. Thirty-three studies (11 in vivo and 22 in vitro) were deemed eligible for inclusion in this analysis. Results of the pooled data showed that povidone-iodine is the most efficacious intervention in vivo in terms of reducing the SARS-CoV-2 salivary viral load, followed by chlorhexidine. The mean difference in the viral load was 86% and 72%, respectively. Similarly, povidone-iodine was associated with the highest log 10 reduction value (LRV) in vitro, followed by cetylpyridinium chloride, (LRV = 2.938 (p < 0.0005) and LRV = 2.907 (p = 0.009), respectively). Povidone-iodine-based oral and nasal preparations showed favourable results in terms of reducing SARS-CoV-2 viral loads both in vivo and in vitro. Considering the limited number of patients in vivo, further studies among larger cohorts are recommended.
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