Abstract: medRxiv preprint doi: https://doi.org/10.1101/2020.09.07.20180448; this version posted September 9, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. All rights reserved. No reuse allowed without permission. EARLY VIRAL CLEARANCE AMONG COVID-19 PATIENTS WHEN GARGLING WITH POVIDONE-IODINE AND ESSENTIAL OILS – A CLINICAL TRIAL *Nurul Azmawati Mohamed1, Nizam Baharom1, Wan Shahida Wan Sulaiman1, Zetti Zainol Rashid2, Wong Kon Ken2, Umi Kalsom Ali2, Siti Norlia Othman2, Muttaqillah Najihan Samat2, Najma Kori3, Petrick Periyasamy3, Nor Azizan Zakaria3, Agni Nhirmal Kumar Sugurmar3, Nur Ezzaty Mohammad Kazmin4, Cheong Xiong Khee3, Siti Mariyam Saniman3, Ilina Isahak1 1 Department of Basic Medical Sciences 2, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Pandan Indah, 55100 Kuala Lumpur, Malaysia 2 Department of Microbiology and Immunology, Hospital Canselor Tuanku Mukhriz, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Kuala Lumpur, Malaysia 3 Department of Medicine, Hospital Canselor Tuanku Mukhriz, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Kuala Lumpur, Malaysia 4 Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Pandan Indah, 55100, Kuala Lumpur, Malaysia Corresponding author: Nurul Azmawati Mohamed Department of Basic Medical Sciences 2 Faculty of Medicine & Health Sciences Universiti Sains Islam Malaysia Jalan Pandan Utama, Pandan Indah 55100 Kuala Lumpur, Malaysia Tel: 603 4289 2400 Email: drnurul@usim.edu.my Declaration: not applicable Funding: none Conflict of Interest: The authors have declared that no conflict of interest exist. Availability of data: upon request NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice. medRxiv preprint doi: https://doi.org/10.1101/2020.09.07.20180448; this version posted September 9, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. All rights reserved. No reuse allowed without permission. Abstract Background: Gargling had been reported to have significant roles in the prevention and treatment of respiratory tract infections. The purpose of this study was to assess the ability of regular gargling to eliminate SARS-CoV-2 in the oropharynx and nasopharynx. Methodology: This pilot, open labeled, randomized, parallel study compared the effect of 30 seconds, 3 times/day gargling using 1% povidone-iodine (PVP-I), essential oils and tap water on SARS-CoV-2 viral clearance among COVID-19 patients in a tertiary hospital in Kuala Lumpur. Progress was monitored by day 4,6 and 12 PCR (Ct value), gargling and symptoms diary as well as clinical observations. Results: Five confirmed Stage 1 COVID-19 patients were recruited for each arm. The age range was from 22 to 56 years old. The majority were males. Two respondents had co-morbidities, which were asthma and obesity. Viral clearance was achieved at day 6 in 100%, 80%, 20% and 0% for 1% PVP-I, essential oils, tap water and control group respectively. Analysis of 1% PVP-I group versus control group showed significant p-value for comparison of PCR results on Day 4, Day 6 and Day 12. Conclusions: This preliminary study showed that gargling with 1% PVP-I..