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All Studies   Meta Analysis       

A Randomized trial on the regular use of potent mouthwash in COVID-19 treatment

Nov 2020  
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Mortality 86% Improvement Relative Risk Ventilation 86% Viral clearance, day 15 18% Viral clearance, day 5 14% Hydrogen Peroxide  Mukhtar et al.  EARLY TREATMENT  RCT Is early treatment with hydrogen peroxide + chlorhexidine gluconate beneficial for COVID-19? RCT 92 patients in Qatar Lower mortality (p=0.24) and ventilation (p=0.24), not sig. c19early.org Mukhtar et al., medRxiv, November 2020 Favorshydrogen peroxide Favorscontrol 0 0.5 1 1.5 2+
21st treatment shown to reduce risk in May 2021, now with p = 0.029 from 7 studies.
Lower risk for viral clearance.
No treatment is 100% effective. Protocols combine treatments.
5,100+ studies for 109 treatments. c19early.org
RCT for mouthwash containing hydrogen peroxide 2% and chlorhexidine gluconate, showing higher discharge, shorter hospital stay, less intubation, and lower mortality with treatment.
risk of death, 85.7% lower, RR 0.14, p = 0.24, treatment 0 of 46 (0.0%), control 3 of 46 (6.5%), NNT 15, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm), including third control death on day 54.
risk of mechanical ventilation, 85.7% lower, RR 0.14, p = 0.24, treatment 0 of 46 (0.0%), control 3 of 46 (6.5%), NNT 15, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm).
risk of no viral clearance, 18.1% lower, RR 0.82, p = 0.16, treatment 28 of 43 (65.1%), control 35 of 44 (79.5%), NNT 6.9, day 15.
risk of no viral clearance, 14.0% lower, RR 0.86, p = 0.01, treatment 37 of 43 (86.0%), control 44 of 44 (100.0%), NNT 7.2, day 5.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Mukhtar et al., 30 Nov 2020, Randomized Controlled Trial, Qatar, preprint, 16 authors, this trial uses multiple treatments in the treatment arm (combined with chlorhexidine gluconate) - results of individual treatments may vary, trial ISRCTN10197987.
This PaperHydrogen Per..All
Abstract: medRxiv preprint doi: https://doi.org/10.1101/2020.11.27.20234997; this version posted April 25, 2021. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license . Title: A randomized trial on the regular use of potent mouthwash in COVID-19 treatment Authors list: Khalid Mukhtar 1 (First & corresponding Author), kmukhter@hamad.qa Suelen Qassim 2, sq1513914@student.qu.edu.qa Shaikha Ali Al Qahtani 3, SALQAHTANI4@hamad.qa Mohamed Ibn-Masud Danjuma 4, mdanjuma@hamad.qa Mohamed Mohamedali 5, mmohamedali@hamad.qa Housamaddeen Al Farhan 6, halfarhan1@hamad.qa Mohammed F. Khudair 7, mkhudhair@hamad.qa Abdel Rehim El Tayeh 8, aeltayeh@hamad.qa Mohammed Al-Dosari 9, maldosari1@hamad.qa Mohamed Elhassan Babiker 10, mbabiker@hamad.qa Ahmed Hassib 11, ahassib1@hamad.qa Rumaisa Mohamed Elmustafa 12, rmohamed31@hamad.qa Wesal Elhadary 13, welhadary@hamad.qa Morwan Abdulkarim 14, mabdulkrim@hamad.qa Rajvir Singh 15, rsingh@hamad.qa Muna Al.Maslamani 16, malmaslamani@hamad.qa Authors affiliation: Hamad Medical Corporation, Doha, QATAR (1, 3, 4, 5, 6, 7, 8,9, 10, 11, 12, 13, 14, 15, 16) Qatar University – Public Health program, Doha, Qatar (2) 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/10.1101/2020.11.27.20234997; this version posted April 25, 2021. 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. It is made available under a CC-BY-NC-ND 4.0 International license . 1. Abstract In this work we tried to study the effect of the regular use of potent mouthwash in COVID19 cases, on the premise that it may speedup the recovery, through the repeated reduction of microbial load, of both, the 2019-nCOV and oral microbiota; thus slowing the disease progression and lowering the incidence of superinfections. Through a randomized controlled trial, a mixed solution of Hydrogen peroxide 2% and chlorhexidine gluconate, to be used for oral rinsing and gargling three times daily, was tested in cases admitted to COVID treatment facility, versus the standard (only) COVID19-treatment protocol, starting with 46 cases in each group, matched in terms of disease severity, of symptoms, and average cycle threshold value (CT-value) for the COVID PCR test on diagnosis. Our findings showed statistically significant improvement in terms of a higher conversion rate to "COVID19-negative PCR" by five days of treatment (6/46 Vs 0/46), improvement in “symptoms severity” after two days of treatment, and less intubation and mortality (0/46 Vs 3/46) with all Pvalue < 0.05. There was also a trend of improvement in other outcome variables, though with no statistically significant difference; namely “shorter hospital stays," "less progression in Oxygen requirements”, “less rate of plasma transfusion”, and better "gross extent of improvement”. Our findings support a beneficial role in treating active cases (Disease) and anticipates better outcome should implemented earlier in course of the disease; thus, suggest a role in limiting the spread (Pandemic), as an additional preventive method. Additionally, we think the repeated reduction in the microbial load..
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