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All Studies   Meta Analysis    Recent:   

A Comparison of the Effects of Chlorhexidine and Sodium Bicarbonate Mouthwashes on COVID-19–Related Symptoms

Karami et al., Iranian Journal of Nursing and Midwifery Research, doi:10.4103/ijnmr.ijnmr_38_23, IRCT20220328054364N1
Jan 2024  
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Mean total symptoms 45% Improvement Relative Risk Mean week 1 symptoms 43% Mean week 2 symptoms 42% Mean week 3 symptoms 79% Mean week 4 symptoms 18% Case 39% Alkalinization  Karami et al.  Prophylaxis  DB RCT Is prophylaxis with alkalinization beneficial for COVID-19? Double-blind RCT 80 patients in Iran (July - October 2022) Lower progression (p=0.14) and fewer cases (p=0.16), not sig. Karami et al., Iranian J. Nursing and .., Jan 2024 Favorsalkalinization Favorscontrol 0 0.5 1 1.5 2+
28th treatment shown to reduce risk in November 2021
*, now with p = 0.0000000046 from 14 studies.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,400+ studies for 79 treatments.
RCT 116 healthcare workers comparing 0.2% chlorhexidine mouthwash (n=36), 7.5% sodium bicarbonate mouthwash (n=40), and placebo (n=40) twice daily for 2 weeks, with symptoms followed for 4 weeks. There were lower symtoms and cases in both treatment groups, with statistical significance for chlorhexidine only. The treatments were stopped after two weeks, results may be better with continued use, more frequent use, and with the addition of nasal use.
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 and reduced systemic side effects.
Study covers chlorhexidine and alkalinization.
relative mean total symptoms, 45.5% better, RR 0.55, p = 0.14, treatment mean 2.52 (±4.99) n=40, control mean 4.62 (±7.37) n=40.
relative mean week 1 symptoms, 42.6% better, RR 0.57, p = 0.39, treatment mean 0.7 (±1.84) n=36, control mean 1.22 (±3.14) n=40.
relative mean week 2 symptoms, 42.0% better, RR 0.58, p = 0.27, treatment mean 0.87 (±2.26) n=36, control mean 1.5 (±2.63) n=40.
relative mean week 3 symptoms, 79.4% better, RR 0.21, p = 0.045, treatment mean 0.2 (±0.72) n=36, control mean 0.97 (±2.16) n=40.
relative mean week 4 symptoms, 18.5% better, RR 0.82, p = 0.77, treatment mean 0.75 (±2.43) n=36, control mean 0.92 (±2.58) n=40.
risk of case, 38.9% lower, RR 0.61, p = 0.16, treatment 11 of 40 (27.5%), control 18 of 40 (45.0%), NNT 5.7.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Karami et al., 9 Jan 2024, Double Blind Randomized Controlled Trial, Iran, peer-reviewed, 4 authors, study period July 2022 - October 2022, trial IRCT20220328054364N1.
This PaperAlkalinizationAll
A Comparison of the Effects of Chlorhexidine and Sodium Bicarbonate Mouthwashes on COVID-19-Related Symptoms
Dr Akram Aarabi, Hanieh Karami, Aygineh Hayrabedian, Valiollah Hajhashemi
Background: Some studies have reported that mouthwashes can decrease the viral load in the mouth, but there is not much information about the effectiveness of mouthwashes on coronavirus disease 2019 (COVID-19). This study was conducted to compare the impact of using two types of mouthwash, chlorhexidine and sodium bicarbonate, on COVID-19 symptoms and infection. Materials and Methods: The present three-group, double-blind clinical trial examined 116 operating room nurses and anesthesia personnel of certain hospitals of Isfahan University of Medical Sciences, Isfahan, Iran. The participants were randomly assigned to three groups: intervention group 1 (chlorhexidine mouthwash), intervention group 2 (sodium bicarbonate mouthwash), and the control group (placebo). Mouthwash was used twice a day (morning and night) for 2 weeks. The participants were monitored in terms of COVID-19-related symptoms for 4 weeks, from the first day of mouthwash use. Results: Fisher's exact test indicated a significant difference between the chlorhexidine and control groups in terms of the onset of COVID-19-related symptoms (p = 0.02). There was no significant difference in the symptoms of COVID-19 between the groups, but the groups were significantly different in terms of all symptoms at a 4-week interval (p = 0.04). Furthermore, headache was less observed in the chlorhexidine (p = 0.007) and sodium bicarbonate (p = 0.03) groups compared to the control group. Conclusions: The use of 0.2% chlorhexidine mouthwash can decrease the onset of COVID-19-related symptoms in health-care workers. In addition, this mouthwash can partially reduce the symptoms of this disease in comparison to the control and sodium bicarbonate groups.
Conflicts of interest Nothing to declare.
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