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Effect of Nasal Irrigation in Children With Omicron Variant of COVID-19 Infection

Liu et al., Ear, Nose & Throat Journal, doi:10.1177/01455613231172337, Jun 2023
https://c19early.org/liu27.html
Recovery time, combi.. 6% Improvement Relative Risk Recovery time, isotoni.. 9% Recovery time, hypert.. 3% Recovery time, com.. b 1% Recovery time, isoto.. b 3% Recovery time, hype.. b -1% Time to viral-, combin.. 24% Time to viral-, isotonic 23% Time to viral-, hyperto.. 24% NaCl for COVID-19  Liu et al.  LATE TREATMENT Is late treatment with NaCl beneficial for COVID-19? Prospective study of 40 patients in China (April - May 2022) Faster viral clearance with NaCl (p=0.000066) c19early.org Liu et al., Ear, Nose & Throat J., Jun 2023 FavorsNaCl Favorscontrol 0 0.5 1 1.5 2+
NaCl for COVID-19
43rd treatment shown to reduce risk in July 2022, now with p = 0.02 from 8 studies.
Lower risk for viral clearance.
No treatment is 100% effective. Protocols combine treatments.
6,000+ studies for 175 treatments. c19early.org
Quasi-experimental study of 60 pediatric patients with Omicron COVID-19 infection showing significant reduction in nucleic acid conversion time with nasal saline irrigation compared to routine treatment. Children aged 3-13 years were divided into three groups: routine treatment (Lianhua Qingwen granules), isotonic saline irrigation plus LhQw, and hypertonic saline irrigation plus LhQw. Both saline irrigation groups showed significantly shorter nucleic acid conversion time and increased lymphocyte counts, though no significant differences were observed in fever duration or cough symptoms. Isotonic saline had no adverse events while hypertonic saline caused mild nasal itching (15%) and pain (10%) in some children. Authors suggest that nasal irrigation may promote recovery in children with Omicron infection by physically removing virus particles from the nasal cavity.
Standard of Care (SOC) for COVID-19 in the study country, China, is poor with low average efficacy for approved treatments1.
recovery time, 5.7% lower, relative time 0.94, p = 0.46, treatment 20, control 20, combined saline groups, fever.
recovery time, 8.7% lower, relative time 0.91, p = 0.46, treatment mean 1.58 (±0.72) n=20, control mean 1.73 (±0.53) n=20, isotonic, fever.
recovery time, 3.5% lower, relative time 0.97, p = 0.74, treatment mean 1.67 (±0.6) n=20, control mean 1.73 (±0.53) n=20, hypertonic, fever.
recovery time, 1.3% lower, relative time 0.99, p = 0.88, treatment 20, control 20, combined saline groups, cough.
recovery time, 3.3% lower, relative time 0.97, p = 0.78, treatment mean 5.8 (±2.4) n=20, control mean 6.0 (±2.16) n=20, isotonic, cough.
recovery time, 0.5% higher, relative time 1.01, p = 0.97, treatment mean 6.03 (±2.27) n=20, control mean 6.0 (±2.16) n=20, hypertonic, cough.
time to viral-, 23.8% lower, relative time 0.76, p < 0.001, treatment 20, control 20, combined saline groups.
time to viral-, 23.2% lower, relative time 0.77, p = 0.007, treatment mean 17.25 (±4.16) n=20, control mean 22.46 (±7.1) n=20, isotonic.
time to viral-, 24.4% lower, relative time 0.76, p = 0.003, treatment mean 16.98 (±2.8) n=20, control mean 22.46 (±7.1) n=20, hypertonic.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Liu et al., 17 Jun 2023, prospective, China, peer-reviewed, mean age 7.3, 5 authors, study period 1 April, 2022 - 1 May, 2022. Contact: w.can@126.com.
Effect of Nasal Irrigation in Children With Omicron Variant of COVID-19 Infection
MD Li Liu, BS Chen Wang, MS Shuangshuang Xie, MS Liang Su, MS Can Wang
Ear, Nose & Throat Journal, doi:10.1177/01455613231172337
Objective: To explore the effect of nasal irrigation on the disappearance of symptoms and nucleic acid conversion in children with Omicron variant. Methods: This quasi-experimental study included children diagnosed with asymptomatic, mild, and moderate Omicron variant infection during the isolation observation period in the Shandong Public Health Clinical Center between April 1, 2022 and May 1, 2022. The children were divided into a routine group (received Lianhua Qingwen (LhQw) Granules), isotonic saline group (received LhQw Granules combined with isotonic saline nasal irrigation), and hypertonic saline group (received LhQw Granules combined with 3% hypertonic saline nasal irrigation), respectively. The primary outcomes were the time of symptom disappearance and nucleic acid conversion time. The secondary outcomes were peripheral white blood cell count (WBC), lymphocyte count (LYM), neutrophil count (NEU), and C-reactive protein (CRP) levels. Results: A total of 60 children (7.26 ± 3.15 years old) were included (20 per group). The average time of nucleic acid conversion in the 2 saline nasal irrigation groups was significantly reduced compared with the routine group (all P < 0.001), while the fever time and cough duration among the 3 groups were comparable (all P > 0.05). LYM count in the 2 saline nasal irrigation groups was significantly increased after treatment compared to before treatment and was significantly higher than in the routine group (all P < 0.05). There was no significant difference in LYM count between the isotonic and hypertonic saline groups (P = 0.76). Additionally, all children in the saline group well tolerated the treatment, and no adverse events occurred in the isotonic saline group. Conclusions: Timely use of saline nasal irrigation may promote nucleic acid conversion in children with Omicron virus infection.
Author Contributions Study concept and design: LS and LL, acquisition of data: CW, Analysis and interpretation of data: SX, Drafting of the manuscript: LL. Critical revision of the manuscript for important intellectual content and study supervision: CW. All authors read and approved the final manuscript. Declaration of Conflicting Interests The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Ethical Approval This work has been carried out in accordance with the Declaration of Helsinki (2000) of the World Medical Association. This study was approved by the ethics committee of Shandong Public Health Clinical Center (GWLCZXEC2022-65). None of the children had any known confirmed infection in the past, and informed consent was signed by their legal guardians.
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DOI record: { "DOI": "10.1177/01455613231172337", "ISSN": [ "0145-5613", "1942-7522" ], "URL": "http://dx.doi.org/10.1177/01455613231172337", "abstract": "<jats:p> Objective: To explore the effect of nasal irrigation on the disappearance of symptoms and nucleic acid conversion in children with Omicron variant. Methods: This quasi-experimental study included children diagnosed with asymptomatic, mild, and moderate Omicron variant infection during the isolation observation period in the Shandong Public Health Clinical Center between April 1, 2022 and May 1, 2022. The children were divided into a routine group (received Lianhua Qingwen (LhQw) Granules), isotonic saline group (received LhQw Granules combined with isotonic saline nasal irrigation), and hypertonic saline group (received LhQw Granules combined with 3% hypertonic saline nasal irrigation), respectively. The primary outcomes were the time of symptom disappearance and nucleic acid conversion time. The secondary outcomes were peripheral white blood cell count (WBC), lymphocyte count (LYM), neutrophil count (NEU), and C-reactive protein (CRP) levels. Results: A total of 60 children (7.26 ± 3.15 years old) were included (20 per group). The average time of nucleic acid conversion in the 2 saline nasal irrigation groups was significantly reduced compared with the routine group (all P &lt; 0.001), while the fever time and cough duration among the 3 groups were comparable (all P &gt; 0.05). LYM count in the 2 saline nasal irrigation groups was significantly increased after treatment compared to before treatment and was significantly higher than in the routine group (all P &lt; 0.05). There was no significant difference in LYM count between the isotonic and hypertonic saline groups ( P = 0.76). Additionally, all children in the saline group well tolerated the treatment, and no adverse events occurred in the isotonic saline group. Conclusions: Timely use of saline nasal irrigation may promote nucleic acid conversion in children with Omicron virus infection. </jats:p>", "alternative-id": [ "10.1177/01455613231172337" ], "author": [ { "ORCID": "https://orcid.org/0000-0001-7425-5127", "affiliation": [ { "name": "Department of liver Diseases, Shandong Public Health Clinical Center, Shandong University, Jinan, China" } ], "authenticated-orcid": false, "family": "Liu", "given": "Li", "sequence": "first" }, { "affiliation": [ { "name": "Department of Medical Service, Shandong Public Health Clinical Center, Shandong University, Jinan, China" } ], "family": "Wang", "given": "Chen", "sequence": "additional" }, { "affiliation": [ { "name": "Department of liver Diseases, Shandong Public Health Clinical Center, Shandong University, Jinan, China" } ], "family": "Xie", "given": "Shuangshuang", "sequence": "additional" }, { "ORCID": "https://orcid.org/0000-0002-1445-8392", "affiliation": [ { "name": "Department of Medical 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Late treatment
is less effective
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