Evaluation of the Efficacy of Mouth Rinses With Commercial Mouthwashes to Decrease Viral Load in Saliva in COVID-19 Patients

Mira et al., NCT05543603, NCT05543603, Jan 2022

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https://c19early.org/mira.html

Chlorhexidine

52nd treatment shown to reduce risk in January 2024, now with p = 0.00000000032 from 4 studies.

Lower risk for progression, cases, and viral clearance.

No treatment is 100% effective. Protocols combine treatments.

5,700+ studies for 145 treatments. c19early.org

48 patient chlorhexidine early treatment RCT with results not reported over 3 years after completion.

4 chlorhexidine RCTs have results missing long after expected1-4
The trials report a total of 512 patients, with 3 trials having actual enrollment of 422, and the other estimated.

Analysis of short-term changes in viral load using PCR may not detect effective treatments because PCR is unable to differentiate between intact infectious virus and non-infectious or destroyed virus particles. For example Tarragó‐Gil, Alemany perform RCTs with cetylpyridinium chloride (CPC) mouthwash that show no difference in PCR viral load, however there was significantly increased detection of SARS-CoV-2 nucleocapsid protein, indicating viral lysis. CPC inactivates SARS-CoV-2 by degrading its membrane, exposing the nucleocapsid of the virus. To better estimate changes in viral load and infectivity, methods like viral culture that can differentiate intact vs. degraded virus are preferred.

Important missing comments or errors? Let us know.

1. Keating et al., SHIELD Study: Using Naso-oropharyngeal Antiseptic Decolonization to Reduce COVID-19 Viral Shedding (SHIELD), NCT04478019, clinicaltrials.gov/study/NCT04478019.clinicaltrials.gov.

2. Xie et al., Oral Rinse to Reduced Expelled Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) During COVID-19 Infection, NCT04931004, clinicaltrials.gov/study/NCT04931004.clinicaltrials.gov.

3. Mira et al., Evaluation of the Efficacy of Mouth Rinses With Commercial Mouthwashes to Decrease Viral Load in Saliva in COVID-19 Patients, NCT05543603, clinicaltrials.gov/study/NCT05543603.clinicaltrials.gov.

4. Jacox et al., Mouth Rinses for Inactivation of COVID-19 (MOR), NCT04584684, clinicaltrials.gov/study/NCT04584684.clinicaltrials.gov.

5. Tarragó‐Gil et al., Randomized clinical trial to assess the impact of oral intervention with cetylpyridinium chloride to reduce salivary SARS‐CoV‐2 viral load, Journal of Clinical Periodontology, doi:10.1111/jcpe.13746.wiley.com, doi.org.

6. Alemany et al., Cetylpyridinium Chloride Mouthwash to Reduce Shedding of Infectious SARS-CoV-2: A Double-Blind Randomized Clinical Trial, Journal of Dental Research, doi:10.1177/00220345221102310.sagepub.com, doi.org.

Mira et al., 8 Jan 2022, Double Blind Randomized Controlled Trial, placebo-controlled, trial NCT05543603 (history).

This Paper Chlorhexidine All

Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ 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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