RCT 120 outpatients in Turkey, showing improved reduction in viral load with PVP-I nasal irrigation.
PVP-I prepared with hypertonic alkaline solution had better results.
Kreutzberger show that SARS-CoV-2 requires acidic pH to infect cells, therefore alkalinization may add additional benefits.
All patients received favipiravir. PVP-I 1% 4 times per day.
Targeted administration to the respiratory tract provides treatment directly
to the typical source of initial SARS-CoV-2 infection and replication, and
allows for rapid onset of action, higher local drug concentration, and reduced
systemic side effects.
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viral load, 83.1% lower, relative load 0.17, p = 0.007, treatment 30, control 30, relative change in viral load, PVP-I vs. control, day 5.
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viral load, 85.5% lower, relative load 0.14, p = 0.001, treatment 30, control 30, relative change in viral load, PVP-I + HANI vs. control, day 5.
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viral load, 82.1% lower, relative load 0.18, p = 0.14, treatment 30, control 30, relative change in viral load, PVP-I vs. control, day 3.
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viral load, 90.8% lower, relative load 0.09, p < 0.001, treatment 30, control 30, relative change in viral load, PVP-I + HANI vs. control, day 3.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Karaaltin et al., 26 Oct 2022, Randomized Controlled Trial, Turkey, preprint, 16 authors, study period September 2021 - October 2021.
EFFECT OF THE POVIDONE IODINE, HYPERTONIC ALKALINE SOLUTION AND SALINE NASAL LAVAGE ON NASOPHARYNGEAL VIRAL LOAD IN COVID-19
Aysegul Karaaltin, Ozgur Yigit, Dogan Cakan, Özer Akgül, Enes Yiğit, Yetkin Zeki Yılmaz, Kays Burak Çakır, Gamze Çiftçi, Nihal Seden, Abdurrahman Çağlıyan, Efe Can, Özgür Dikme, Yalçın Hacıoğlu, Ilker Inanç Balkan, Özgün Enver, Ahmet Ozdogan
doi:10.22541/au.166675335.56566797/v1
Objective: The causative virus of COVID-19 is SARS-CoV-2. The aim of the present study was to invastigate the in vivo virucidal activity of nasal irrigation with saline, nasal irrigation with Povidone-iodine (PVP-I) 1%, nasal irrigation with hypertonic alkaline and nasal irrigation with PVP-I 1% against SARS CoV-2. Design: The present study was a prospective randomized clinical trial. Setting: A multicenter study involving tertiary care centers. Participants: The study included adult outpatients whose qualitative SARS-CoV-2 RT-PCR tests in nasopharyngeal swabs were positive. One hundred twenty patients divided into four equal groups. Standard COVID-19 treatment was given to group 1 (n=30), nasal irrigation containing isotonic solution was added to patients' treatment in group 2 (n=30), nasal irrigation containing 1% PVP solution was added to patients' treatment in group 3(n=30), and nasal irrigation containing 1% PVP solution and nasal irrigation containing hypertonic alkaline solution was added to patients' treatment in group 4 (n=30). Main outcome measures: On the first day of diagnosis (day 0), nasopharyngeal swab samples were taken, on the 3rd and 5th days the nasopharyngeal viral load reduction in quantitative RT-PCR tests were calculated. Results: Between the 0-3rd Day and 0-5th days, the nasopharyngeal viral load reduction was significant in all groups (p< .05). In paired comparisons of groups, the nasopharyngeal viral load decrease in group 4 in first 3 days was significantly lower than all groups (p < .05). The nasopharyngeal viral load degrease in groups 3 and 4 in the first 5 days were significantly lower than group 1 (p < .05). Conclussion: This study was reveal that the use of hypertonic alkaline nasal irrigation together with 1% povidone-iodine was more effective in reducing viral load in the early period. The decreased nasopharyngeal viral load may reduce the carriage of infectious SARS-CoV-2 in patients. Our results suggest that 1% povidone-iodine and hypertonic alkaline nasal irrigation may be promising modality to prevent the COVID-19 epidemic.
alkaline-solution-and-saline-nasal-lavage-on-nasopharyngeal-viral-load-in-covid-19 Hosted file table 1.docx available at https://authorea.com/users/337860/articles/592062-effect-of-thepovidone-iodine-hypertonic-alkaline-solution-and-saline-nasal-lavage-on-nasopharyngealviral-load-in-covid-19 Hosted file
