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Effect of nasal irrigation in adults infected with Omicron variant of COVID-19: A quasi-experimental study

Liu et al., Frontiers in Public Health, doi:10.3389/fpubh.2022.1046112, Jan 2023
https://c19early.org/liu28.html
Recovery time 3% Improvement Relative Risk Time to viral- 40% NaCl for COVID-19  Liu et al.  LATE TREATMENT Is late treatment with NaCl beneficial for COVID-19? Prospective study of 80 patients in China (April - May 2022) Faster viral clearance with NaCl (p<0.000001) c19early.org Liu et al., Frontiers in Public Health, Jan 2023 FavorsNaCl Favorscontrol 0 0.5 1 1.5 2+
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Quasi-experimental study of 80 COVID-19 patients showing shorter nucleic acid negative conversion time but no significant difference in symptom duration with hypertonic saline nasal irrigation in adults infected with Omicron variant. Data is not clear in this study, e.g., Table 1 shows only 11 patients were not asymptomatic in the treatment group, however 12 patients had fever. The groups in Table 2 and Figure 1 are reversed for nucleic acid negative conversion. The study compared conventional treatment (Lianhua Qingwen granules and traditional Chinese medicine) to the same treatment plus 3% hypertonic saline nasal irrigation. After adjustment for confounding factors, the nasal irrigation group had significantly faster viral clearance. There was no significant difference in symptom resolution time. Half of the patients were refractory patients that were isolated for observation for more than 20 days. The treatment group has significantly higher history of smoking (p=0.016) and the N gene Ct value was significantly lower at baseline in the treatment group (p<0.001). Adjusted results are only provided for nucleic acid negative conversion time.
Standard of Care (SOC) for COVID-19 in the study country, China, is poor with low average efficacy for approved treatments1.
recovery time, 2.8% lower, relative time 0.97, p = 0.69, treatment mean 3.44 (±0.73) n=40, control mean 3.54 (±1.39) n=40, fever.
time to viral-, 39.6% lower, relative time 0.60, p < 0.001, treatment mean 17.58 (±7.31) n=40, control mean 29.1 (±3.7) n=40.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Liu et al., 9 Jan 2023, prospective, China, peer-reviewed, mean age 41.3, 5 authors, study period 1 April, 2022 - 1 May, 2022. Contact: su_li@126.com, zhuchengbao@126.com.
Effect of nasal irrigation in adults infected with Omicron variant of COVID-: A quasi-experimental study
Senthil Kumaran Satyanarayanan, Barani Kumar Rajendran, Amani Odeh, Liang Su, Li Liu, Shuangshuang Xie, Cheng Li, Chengbao Zhu
Objective: To investigate the effect of nasal irrigation on the duration of symptoms and nucleic acid conversion in adults infected with the Omicron variant of COVID-. Methods: This quasi-experimental study enrolled patients diagnosed with asymptomatic, mild, or moderate Omicron infection at the Shandong Public Health Clinical Center between April , and May , . Patients were divided into two groups to receive Lianhua Qingwen granules and traditional Chinese medicine (TCM) prescriptions (conventional group) and % hypertonic saline nasal irrigation based on conventional treatment (nasal irrigation groups), respectively. Primary outcomes were symptom disappearance time and nucleic acid negative conversion time. Secondary outcomes were peripheral blood white blood cell (WBC), lymphocyte (LYM) count, neutrophil (NEU) count, C-reactive protein (CRP) level, and chest CT examination findings. Results: Eighty patients were included ( patients/group). Multiple linear regression analysis showed that, after adjustment for comorbidities, smoking history, LYM count, and Ct values of N gene, the patients in the nasal irrigation group were more likely to get lower nucleic acid negative conversion time (β = -. , % CI: -. -. , P < . ) compared with the conventional group. The symptom disappearance time showed no significant improvement (P > . ). Subgroup analysis for treatment-naïve patients in the nasal irrigation group showed similar nucleic acid negative conversion time improvement (P = . ). Conclusion: Early nasal irrigation shortens the nucleic acid negative conversion time in adults infected with the Omicron variant but without improvements in symptom disappearance time.
Ethics statement The studies involving human participants were reviewed and approved by Shandong Public Health Clinical Center. The patients/participants provided their written informed consent to participate in this study. Author contributions LL carried out the studies, participated in collecting data, and drafted the manuscript. LS and CZ performed the statistical analysis and participated in its design. SX Conflict of interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Publisher's note All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher. Supplementary material The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fpubh. 2022.1046112/full#supplementary-material
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DOI record: { "DOI": "10.3389/fpubh.2022.1046112", "ISSN": [ "2296-2565" ], "URL": "http://dx.doi.org/10.3389/fpubh.2022.1046112", "abstract": "<jats:sec><jats:title>Objective</jats:title><jats:p>To investigate the effect of nasal irrigation on the duration of symptoms and nucleic acid conversion in adults infected with the Omicron variant of COVID-19.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>This quasi-experimental study enrolled patients diagnosed with asymptomatic, mild, or moderate Omicron infection at the Shandong Public Health Clinical Center between April 1, 2022 and May 1, 2022. Patients were divided into two groups to receive Lianhua Qingwen granules and traditional Chinese medicine (TCM) prescriptions (conventional group) and 3% hypertonic saline nasal irrigation based on conventional treatment (nasal irrigation groups), respectively. Primary outcomes were symptom disappearance time and nucleic acid negative conversion time. Secondary outcomes were peripheral blood white blood cell (WBC), lymphocyte (LYM) count, neutrophil (NEU) count, C-reactive protein (CRP) level, and chest CT examination findings.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Eighty patients were included (40 patients/group). Multiple linear regression analysis showed that, after adjustment for comorbidities, smoking history, LYM count, and Ct values of N gene, the patients in the nasal irrigation group were more likely to get lower nucleic acid negative conversion time (β = −11.052, 95% CI: −8.277–13.827, <jats:italic>P</jats:italic> &amp;lt; 0.001) compared with the conventional group. The symptom disappearance time showed no significant improvement (<jats:italic>P</jats:italic> &amp;gt; 0.05). Subgroup analysis for treatment-naïve patients in the nasal irrigation group showed similar nucleic acid negative conversion time improvement (<jats:italic>P</jats:italic> = 0.038).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Early nasal irrigation shortens the nucleic acid negative conversion time in adults infected with the Omicron variant but without improvements in symptom disappearance time.</jats:p></jats:sec>", "alternative-id": [ "10.3389/fpubh.2022.1046112" ], "author": [ { "affiliation": [], "family": "Liu", "given": "Li", "sequence": "first" }, { "affiliation": [], "family": "Xie", "given": "Shuangshuang", "sequence": "additional" }, { "affiliation": [], "family": "Li", "given": "Cheng", "sequence": "additional" }, { "affiliation": [], "family": "Su", "given": "Liang", "sequence": "additional" }, { "affiliation": [], "family": "Zhu", "given": "Chengbao", "sequence": "additional" } ], "container-title": "Frontiers in Public Health", "container-title-short": "Front. 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"399", "year": "2022" }, { "DOI": "10.1002/jmv.25685", "article-title": "Coronavirus infections and immune responses", "author": "Li", "doi-asserted-by": "publisher", "first-page": "424", "journal-title": "J Med Virol.", "key": "B33", "volume": "92", "year": "2020" }, { "DOI": "10.26355/eurrev_202007_22291", "article-title": "Clinical features, laboratory findings and predictors of death in hospitalized patients with COVID-19 in Sardinia, Italy", "author": "De Vito", "doi-asserted-by": "publisher", "first-page": "7861", "journal-title": "Eur Rev Med Pharmacol Sci.", "key": "B34", "volume": "24", "year": "2020" }, { "DOI": "10.1186/s12890-021-01422-9", "article-title": "Association between peripheral lymphocyte count and the mortality risk of COVID-19 inpatients", "author": "Wang", "doi-asserted-by": "publisher", "first-page": "55", "journal-title": "BMC Pulm Med.", "key": "B35", "volume": "21", "year": "2021" }, { "DOI": "10.1001/jamanetworkopen.2022.10871", "article-title": "Assessment of T-cell reactivity to the SARS-CoV-2 Omicron variant by immunized individuals", "author": "De Marco", "doi-asserted-by": "publisher", "first-page": "e2210871", "journal-title": "JAMA Netw Open.", "key": "B36", "volume": "5", "year": "2022" }, { "DOI": "10.1038/s41586-022-04479-6", "article-title": "SARS-CoV-2 Omicron variant replication in human bronchus and lung ex vivo", "author": "Hui", "doi-asserted-by": "publisher", "first-page": "715", "journal-title": "Nature", "key": "B37", "volume": "603", "year": "2022" }, { "DOI": "10.1001/jamaoto.2020.1622", "article-title": "Benefits and safety of nasal saline irrigations in a pandemic-washing COVID-19 away", "author": "Farrell", "doi-asserted-by": "publisher", "first-page": "787", "journal-title": "JAMA Otolaryngol Head Neck Surg.", "key": "B38", "volume": "146", "year": "2020" }, { "DOI": "10.7189/jogh.10.010332", "article-title": "Hypertonic saline nasal irrigation and gargling should be considered as a treatment option 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Late treatment
is less effective
Please send us corrections, updates, or comments. c19early involves the extraction of 200,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. IMA and WCH provide treatment protocols.
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