Abstract: medRxiv preprint doi: https://doi.org/10.1101/2021.02.25.21252488; this version posted March 1, 2021. The copyright holder for this preprint
(which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.
It is made available under a CC-BY-NC-ND 4.0 International license .
Povidone iodine, hydrogen peroxide and chlorhexidine mouthwashes reduce SARS-CoV2
burden in whole mouth fluid and respiratory droplets
Bagavad Gita Jayaraman1*, Gunaseelan Rajan1, Priya Kannian2*, Chandra Lavanya4, Krittika
Ravichandran1, Nagalingeswaran Kumarasamy3, Kannan Ranganathan4, Veeraraghavan Aswini2,
Pasuvaraj Mahanathi2, Stephen Challacombe5, Jennifer Webster-Cyriaque6, Newell W
Johnson1,3,5,7
1
2
Chennai Dental Research Foundation, Chennai, India
VHS Laboratory Services, Department of Clinical Research, VHS Hospital, Chennai, India
3
VHS-Infectious Diseases Medical Centre, VHS Hospital, Chennai, India
4
Department of Oral Pathology, Ragas Dental College and Hospital, Chennai, India
5
Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, UK
6
University of North Carolina, Chapel Hill, USA
7
Menzies Health Institute Queensland, Griffith University, Queensland, Australia
Address for Correspondence:
* Dr. Bagavad Gita Jayaraman
Research Scientist
Chennai Dental Research Foundation
No. 56, Dr. R. K. Salai
6th Floor, Mylapore
Chennai – 600004
Tamil Nadu, India
Ph: 91-44-42103440
Email: gita70.geetha@gmail.com
* Dr. Priya Kannian
Scientist & Head
Department of Clinical Research
VHS Hospital
Rajiv Gandhi Salai
Taramani, Chennai – 600113
Tamil Nadu, India
Ph: 91-44-22541972
Email: priyakannian@gmail.com
Word count: 599 words
1
NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice.
medRxiv preprint doi: https://doi.org/10.1101/2021.02.25.21252488; this version posted March 1, 2021. The copyright holder for this preprint
(which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.
It is made available under a CC-BY-NC-ND 4.0 International license .
{ 'institution': [{'name': 'medRxiv'}],
'indexed': {'date-parts': [[2023, 8, 22]], 'date-time': '2023-08-22T17:16:08Z', 'timestamp': 1692724568451},
'posted': {'date-parts': [[2021, 3, 1]]},
'group-title': 'Infectious Diseases (except HIV/AIDS)',
'reference-count': 5,
'publisher': 'Cold Spring Harbor Laboratory',
'content-domain': {'domain': [], 'crossmark-restriction': False},
'accepted': {'date-parts': [[2021, 3, 1]]},
'abstract': '<jats:p>SARS-CoV2 is transmitted primarily through oral mouth secretions and respiratory '
'droplets. Commercial mouthwashes, povidone iodine (PI), hydrogen peroxide (HP) and '
'chlorhexidine (CHX) have been tested in cell culture and RT-PCR studies for their efficacy to '
'reduce SARS-CoV2 burden. Here, we evaluated SARS-CoV2 burden in whole mouth fluid (WMF) and '
'respiratory droplets (RD) samples before and after the use of PI, HP or CHX mouthwashes in '
'hospitalized COVID-19 patients using RT-PCR and rapid antigen test (RAT). Thirty-six '
'SARS-CoV2 RT-PCR-positive in-patients were randomly assigned to one of the four groups: 20 '
'and 60 minutes after 1% w/v PI or 1.5% HP; 90 and 180 minutes after 1.5% HP or 0.2% w/v CHX. '
'WMF and RD samples were collected concurrently at baseline and after the two different time '
'points. RD (92%) showed a higher reduction in SARS-CoV2 burden than WMF samples (50%; '
'p=0.008). SARS-CoV2 burden was statistically lower at both 20 minutes (p=0.02) and 60 minutes '
'(p=0.03) with PI; at 20 minutes with HP (p=0.0001); and 90 minutes with CHX (p=0.04). The '
'overall and individual mean logarithmic reductions in the WMF and RD samples were greater '
'than 1.0 at 20, 60 and 90 minutes after PI, HP or CHX. RAT-positive patients at 90 minutes '
'post-treatment (n=3) demonstrated a one log increase in virus copies. Among the three '
'RAT-negative post-treatment patients, SARS-CoV2 burden declined by one log in two while the '
'third patient had a slight increase in RNA copies. In conclusion, we have shown for the first '
'time that the mouthwashes, PI, HP and CHX can reduce the SARS-CoV2 burden in the concurrently '
'collected RD and WMF samples. RAT is more appropriate than RT-PCR to evaluate the efficacy of '
'the mouthwashes.</jats:p>',
'DOI': '10.1101/2021.02.25.21252488',
'type': 'posted-content',
'created': {'date-parts': [[2021, 3, 1]], 'date-time': '2021-03-01T17:25:17Z', 'timestamp': 1614619517000},
'source': 'Crossref',
'is-referenced-by-count': 4,
'title': 'Povidone iodine, hydrogen peroxide and chlorhexidine mouthwashes reduce SARS-CoV2 burden in '
'whole mouth fluid and respiratory droplets',
'prefix': '10.1101',
'author': [ {'given': 'Bagavad Gita', 'family': 'Jayaraman', 'sequence': 'first', 'affiliation': []},
{'given': 'Gunaseelan', 'family': 'Rajan', 'sequence': 'additional', 'affiliation': []},
{ 'ORCID': 'http://orcid.org/0000-0002-2790-6676',
'authenticated-orcid': False,
'given': 'Priya',
'family': 'Kannian',
'sequence': 'additional',
'affiliation': []},
{'given': 'Chandra', 'family': 'Lavanya', 'sequence': 'additional', 'affiliation': []},
{'given': 'Krittika', 'family': 'Ravichandran', 'sequence': 'additional', 'affiliation': []},
{ 'given': 'Nagalingeswaran',
'family': 'Kumarasamy',
'sequence': 'additional',
'affiliation': []},
{'given': 'Kannan', 'family': 'Ranganathan', 'sequence': 'additional', 'affiliation': []},
{'given': 'Veeraraghavan', 'family': 'Aswini', 'sequence': 'additional', 'affiliation': []},
{'given': 'Pasuvaraj', 'family': 'Mahanathi', 'sequence': 'additional', 'affiliation': []},
{'given': 'Stephen', 'family': 'Challacombe', 'sequence': 'additional', 'affiliation': []},
{ 'given': 'Jennifer',
'family': 'Webster-Cyriaque',
'sequence': 'additional',
'affiliation': []},
{ 'ORCID': 'http://orcid.org/0000-0001-5866-262X',
'authenticated-orcid': False,
'given': 'Newell W',
'family': 'Johnson',
'sequence': 'additional',
'affiliation': []}],
'member': '246',
'reference': [ { 'key': '2021030308050679000_2021.02.25.21252488v1.1',
'doi-asserted-by': 'crossref',
'unstructured': 'Carrouel F , Goncalves LS , Conte MP , et al. Antiviral Activity of '
'Reagents in Mouth Rinses against SARS-CoV-2. J Dent Res. 2020 Oct 22 : '
'0022034520967933.',
'DOI': '10.1177/0022034520967933'},
{ 'key': '2021030308050679000_2021.02.25.21252488v1.2',
'doi-asserted-by': 'publisher',
'DOI': '10.1001/jamaoto.2020.5490'},
{ 'key': '2021030308050679000_2021.02.25.21252488v1.3',
'doi-asserted-by': 'publisher',
'DOI': '10.1111/odi.13793'},
{ 'key': '2021030308050679000_2021.02.25.21252488v1.4',
'doi-asserted-by': 'publisher',
'DOI': '10.1111/odi.13526'},
{ 'key': '2021030308050679000_2021.02.25.21252488v1.5',
'doi-asserted-by': 'publisher',
'DOI': '10.1101/2020.09.14.20186494'}],
'container-title': [],
'original-title': [],
'link': [ { 'URL': 'https://syndication.highwire.org/content/doi/10.1101/2021.02.25.21252488',
'content-type': 'unspecified',
'content-version': 'vor',
'intended-application': 'similarity-checking'}],
'deposited': { 'date-parts': [[2021, 3, 3]],
'date-time': '2021-03-03T16:05:25Z',
'timestamp': 1614787525000},
'score': 1,
'resource': {'primary': {'URL': 'http://medrxiv.org/lookup/doi/10.1101/2021.02.25.21252488'}},
'subtitle': [],
'short-title': [],
'issued': {'date-parts': [[2021, 3, 1]]},
'references-count': 5,
'URL': 'http://dx.doi.org/10.1101/2021.02.25.21252488',
'relation': {},
'published': {'date-parts': [[2021, 3, 1]]},
'subtype': 'preprint'}
