The short-term effect of different chlorhexidine forms versus povidone iodine mouth rinse in minimizing the oral SARS-CoV-2 viral load: An open label randomized controlled clinical trial study

{ 'indexed': {'date-parts': [[2024, 3, 4]], 'date-time': '2024-03-04T16:07:01Z', 'timestamp': 1709568421710}, 'reference-count': 33, 'publisher': 'Ovid Technologies (Wolters Kluwer Health)', 'issue': '30', 'license': [ { 'start': { 'date-parts': [[2022, 7, 29]], 'date-time': '2022-07-29T00:00:00Z', 'timestamp': 1659052800000}, 'content-version': 'unspecified', 'delay-in-days': 0, 'URL': 'http://creativecommons.org/licenses/by-nc/4.0/'}], 'content-domain': {'domain': [], 'crossmark-restriction': False}, 'abstract': '<jats:p>Several investigations evaluated the possibility of different types of mouth wash ' 'rinse in minimizing the SARS-CoV-2 load. However, results still controversial. The study aim ' 'is to assess the short-term efficiency of several over-the-counter mouth rinses and lozenges ' 'in minimizing the salivary viral load for SARS-CoV-2 in patients with confirmed COVID-19 in ' 'comparison to saline. This is a randomized controlled clinical trial with 4 arms. The ' 'recruited cases were randomized using a simple randomization technique and were assigned to ' 'chlorhexidine digluconate mouth rinse (CHX mouth rinse), 2\u2009mg of chlorhexidine ' 'digluconate lozenges (CHX lozenges), povidone iodine mouth rinse (PVP-I mouth rinse) or ' 'saline as a control group. Saliva were collected from all study subjects by passive drool ' 'technique at two time points. First, prior to intervention with mouth rinse or the lozenges, ' 'the baseline saliva sample was collected. Second saliva samples were collected immediately ' 'after the mouth rinse. Real time PCR was conducted and the value threshold cycle (Ct) for ' 'each sample was recorded. Majority of the participants had an education level of high school ' 'or less (60%), were married (68.3), males (58.3%), and non-smokers (58.5%). No statistically ' 'significant differences between groups at the two times test (<jats:italic ' 'toggle="yes">P</jats:italic> &gt; .05). However, a significant decrease of salivary viral ' 'load in all four groups combined (<jats:italic toggle="yes">P</jats:italic>-value for E genes ' '= .027, and for S genes = .006), and in PVP-I mouth rinse specifically (<jats:italic ' 'toggle="yes">P</jats:italic> = .003 and <jats:italic toggle="yes">P</jats:italic> = .045, ' 'respectively). Povidone iodine mouth rinse showed a potential influence on the reduction of ' 'the viral load on a short-term basis. However, longer-term studies of the effect of these ' 'products should be conducted.</jats:p>', 'DOI': '10.1097/md.0000000000028925', 'type': 'journal-article', 'created': {'date-parts': [[2022, 8, 10]], 'date-time': '2022-08-10T22:06:38Z', 'timestamp': 1660169198000}, 'page': 'e28925', 'source': 'Crossref', 'is-referenced-by-count': 11, 'title': 'The short-term effect of different chlorhexidine forms versus povidone iodine mouth rinse in ' 'minimizing the oral SARS-CoV-2 viral load: An open label randomized controlled clinical trial ' 'study', 'prefix': '10.1097', 'volume': '101', 'author': [ { 'ORCID': 'http://orcid.org/0000-0003-2723-0255', 'authenticated-orcid': False, 'given': 'Zuhair S.', 'family': 'Natto', 'sequence': 'first', 'affiliation': [ { 'name': 'Department of Dental Public Health, Faculty of Dentistry, King ' 'Abdulaziz University, Jeddah, Saudi Arabia'}]}, { 'given': 'Muhammed A.', 'family': 'Bakhrebah', 'sequence': 'additional', 'affiliation': [ { 'name': 'Life Science and Environment Research Institute, King Abdulaziz ' 'City for Science and Technology (KACST), Riyadh, Saudi Arabia'}]}, { 'given': 'Marwah', 'family': 'Afeef', 'sequence': 'additional', 'affiliation': [ { 'name': 'Study and Research Department, King Fahad General Hospital, ' 'Jeddah, Saudi Arabia'}]}, { 'given': 'Samiah', 'family': 'Al-Harbi', 'sequence': 'additional', 'affiliation': [ { 'name': 'Intensive Care Unit, King Fahad General Hospital, Jeddah, Saudi ' 'Arabia'}]}, { 'given': 'Majed S.', 'family': 'Nassar', 'sequence': 'additional', 'affiliation': [ { 'name': 'Life Science and Environment Research Institute, King Abdulaziz ' 'City for Science and Technology (KACST), Riyadh, Saudi Arabia'}]}, { 'given': 'Abdulkarim F.', 'family': 'Alhetheel', 'sequence': 'additional', 'affiliation': [ {'name': 'King Khalid University Hospital, Riyadh, Saudi Arabia'}, { 'name': 'Department of Pathology, King Saud University, Riyadh, Saudi ' 'Arabia.'}]}, { 'given': 'Heba', 'family': 'Ashi', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Dental Public Health, Faculty of Dentistry, King ' 'Abdulaziz University, Jeddah, Saudi Arabia'}]}], 'member': '276', 'published-online': {'date-parts': [[2022, 7, 29]]}, 'reference': [ { 'key': 'R1-20230928', 'doi-asserted-by': 'crossref', 'first-page': '1476', 'DOI': '10.1056/NEJMc2003100', 'article-title': 'SARS-CoV-2 infection among travelers returning from Wuhan, China.', 'volume': '382', 'author': 'Ng', 'year': '2020', 'journal-title': 'N Engl J Med'}, { 'key': 'R2-20230928', 'doi-asserted-by': 'crossref', 'first-page': '2310', 'DOI': '10.1002/jmv.25995', 'article-title': 'High prevalence of olfactory and taste disorder during SARS-CoV-2 ' 'infection in outpatients.', 'volume': '92', 'author': 'De Maria', 'year': '2020', 'journal-title': 'J Med Virol'}, { 'key': 'R3-20230928', 'first-page': 'e212', 'article-title': 'Cutaneous manifestations in COVID-19: a first perspective.', 'volume': '34', 'author': 'Recalcati', 'year': '2020', 'journal-title': 'J Eur Acad Dermatol Venereol'}, { 'key': 'R4-20230928', 'doi-asserted-by': 'crossref', 'first-page': '3151', 'DOI': '10.3390/ijerph17093151', 'article-title': 'COVID-19: present and future challenges for dental practice.', 'volume': '17', 'author': 'Odeh', 'year': '2020', 'journal-title': 'Int J Environ Res Public Health'}, { 'key': 'R5-20230928', 'doi-asserted-by': 'crossref', 'first-page': '722', 'DOI': '10.1177/0194599820934380', 'article-title': 'Olfactory and oral manifestations of COVID-19: sex-related symptoms-a ' 'potential pathway to early diagnosis.', 'volume': '163', 'author': 'Biadsee', 'year': '2020', 'journal-title': 'Otolaryngol Head Neck Surg'}, { 'key': 'R6-20230928', 'doi-asserted-by': 'crossref', 'first-page': '612', 'DOI': '10.1002/jmv.25735', 'article-title': 'Clinical characteristics of hospitalized patients with SARS-CoV-2 ' 'infection: a single arm meta-analysis.', 'volume': '92', 'author': 'Sun', 'year': '2020', 'journal-title': 'J Med Virol'}, { 'key': 'R8-20230928', 'doi-asserted-by': 'crossref', 'first-page': '1', 'DOI': '10.1186/s12879-021-05950-x', 'article-title': 'Serial interval and incubation period of COVID-19: a systematic review ' 'and meta-analysis.', 'volume': '21', 'author': 'Alene', 'year': '2021', 'journal-title': 'BMC Infect Dis'}, { 'key': 'R9-20230928', 'doi-asserted-by': 'crossref', 'first-page': 'e195', 'DOI': '10.3346/jkms.2020.35.e195', 'article-title': 'Clinical significance of a high SARS-CoV-2 viral load in the saliva.', 'volume': '35', 'author': 'Yoon', 'year': '2020', 'journal-title': 'J Korean Med Sci'}, { 'key': 'R10-20230928', 'doi-asserted-by': 'crossref', 'first-page': '584', 'DOI': '10.1016/j.joen.2020.03.008', 'article-title': 'Coronavirus disease 19 (COVID-19): implications for clinical dental ' 'care.', 'volume': '46', 'author': 'Ather', 'year': '2020', 'journal-title': 'J Endod'}, { 'key': 'R11-20230928', 'doi-asserted-by': 'crossref', 'first-page': '874', 'DOI': '10.1177/00220345900690030901', 'article-title': 'In vitro virucidal effectiveness of a 0.12%-chlorhexidine gluconate ' 'mouthrinse.', 'volume': '69', 'author': 'Bernstein', 'year': '1990', 'journal-title': 'J Dent Res'}, { 'key': 'R12-20230928', 'doi-asserted-by': 'crossref', 'first-page': '610', 'DOI': '10.1034/j.1600-051x.2001.028007610.x', 'article-title': 'In vitro effect of oral antiseptics on human immunodeficiency virus-1 ' 'and herpes simplex virus type 1.', 'volume': '28', 'author': 'Baqui', 'year': '2001', 'journal-title': 'J Clin Periodontol'}, { 'key': 'R13-20230928', 'doi-asserted-by': 'crossref', 'first-page': '39', 'DOI': '10.1016/j.jdsr.2021.03.001', 'article-title': 'Can povidone iodine gargle/mouthrinse inactivate SARS-CoV-2 and ' 'decrease the risk of nosocomial and community transmission during the ' 'COVID-19 pandemic? An evidence-based update.', 'volume': '57', 'author': 'Chopra', 'year': '2021', 'journal-title': 'Jpn Dent Sci Rev'}, { 'key': 'R14-20230928', 'doi-asserted-by': 'crossref', 'first-page': 'e07346', 'DOI': '10.1016/j.heliyon.2021.e07346', 'article-title': 'Salivary SARS-CoV-2 load reduction with mouthwash use: a randomized ' 'pilot clinical trial.', 'volume': '7', 'author': 'Eduardo', 'year': '2021', 'journal-title': 'Heliyon'}, { 'key': 'R15-20230928', 'doi-asserted-by': 'crossref', 'first-page': '1289', 'DOI': '10.1093/infdis/jiaa471', 'article-title': 'Virucidal efficacy of different oral rinses against severe acute ' 'respiratory syndrome coronavirus 2.', 'volume': '222', 'author': 'Meister', 'year': '2020', 'journal-title': 'J Infect Dis'}, { 'key': 'R16-20230928', 'doi-asserted-by': 'crossref', 'first-page': '305', 'DOI': '10.1007/s15010-020-01563-9', 'article-title': 'Efficacy of commercial mouth-rinses on SARS-CoV-2 viral load in saliva: ' 'randomized control trial in Singapore.', 'volume': '49', 'author': 'Seneviratne', 'year': '2021', 'journal-title': 'Infection'}, { 'key': 'R17-20230928', 'doi-asserted-by': 'crossref', 'first-page': 'zqaa002', 'DOI': '10.1093/function/zqaa002', 'article-title': 'Potential role of oral rinses targeting the viral lipid envelope in ' 'SARS-CoV-2 infection.', 'volume': '1', 'author': 'O’Donnell', 'year': '2020', 'journal-title': 'Function (Oxf)'}, { 'key': 'R18-20230928', 'doi-asserted-by': 'crossref', 'first-page': '83', 'DOI': '10.1111/idh.12078', 'article-title': 'The effect of chlorhexidine dentifrice or gel versus chlorhexidine ' 'mouthwash on plaque, gingivitis, bleeding and tooth discoloration: a ' 'systematic review.', 'volume': '13', 'author': 'Supranoto', 'year': '2015', 'journal-title': 'Int J Dent Hyg'}, { 'key': 'R19-20230928', 'doi-asserted-by': 'crossref', 'first-page': '581', 'DOI': '10.1007/s40121-019-00260-x', 'article-title': 'Infectious disease management and control with povidone iodine.', 'volume': '8', 'author': 'Eggers', 'year': '2019', 'journal-title': 'Infect Dis Ther'}, { 'key': 'R20-20230928', 'doi-asserted-by': 'crossref', 'first-page': '529', 'DOI': '10.1111/jopr.13209', 'article-title': 'Rapid in-vitro inactivation of severe acute respiratory syndrome ' 'coronavirus 2 (SARS-CoV-2) using povidone-iodine oral antiseptic rinse.', 'volume': '29', 'author': 'Bidra', 'year': '2020', 'journal-title': 'J Prosthodont'}, { 'key': 'R21-20230928', 'doi-asserted-by': 'crossref', 'first-page': '656', 'DOI': '10.1038/s41415-020-1589-4', 'article-title': 'Povidone iodine.', 'volume': '228', 'author': 'Challacombe', 'year': '2020', 'journal-title': 'Br Dent J'}, { 'key': 'R22-20230928', 'doi-asserted-by': 'crossref', 'first-page': '16', 'DOI': '10.1002/JPER.18-0183', 'article-title': 'Association between time since quitting smoking and periodontitis in ' 'former smokers in the National Health and Nutrition Examination Surveys ' '(NHANES) 2009 to 2012.', 'volume': '90', 'author': 'ALHarthi', 'year': '2012', 'journal-title': 'J Periodontol'}, { 'key': 'R23-20230928', 'first-page': '9188', 'article-title': 'A contemporary look at COVID-19 medications: available and potentially ' 'effective drugs.', 'volume': '24', 'author': 'Alshaeri', 'year': '2020', 'journal-title': 'Eur Rev Med Pharmacol Sci'}, { 'key': 'R24-20230928', 'doi-asserted-by': 'crossref', 'first-page': '101584', 'DOI': '10.1016/j.jebdp.2021.101584', 'article-title': 'In vivo evaluation of the virucidal efficacy of chlorhexidine and ' 'povidone-iodine mouthwashes against salivary SARS-CoV-2. A ' 'randomized-controlled clinical trial.', 'volume': '21', 'author': 'Elzein', 'year': '2021', 'journal-title': 'J Evid Based Dent Pract'}, { 'key': 'R25-20230928', 'doi-asserted-by': 'crossref', 'first-page': '260', 'DOI': '10.1186/s12903-019-0955-6', 'article-title': 'Annual alveolar bone loss in older adults taking oral bisphosphonate: a ' 'retrospective cohort study.', 'volume': '19', 'author': 'Helmi', 'year': '2019', 'journal-title': 'BMC Oral Health'}, { 'key': 'R26-20230928', 'doi-asserted-by': 'crossref', 'first-page': '28', 'DOI': '10.1186/s12903-020-1015-y', 'article-title': 'Annual alveolar bone loss in subjects with cardiovascular disease ' 'adjusting for associated systemic diseases and risk factors: a ' 'retrospective study.', 'volume': '20', 'author': 'Helmi', 'year': '2020', 'journal-title': 'BMC Oral Health'}, { 'key': 'R27-20230928', 'doi-asserted-by': 'crossref', 'first-page': '254', 'DOI': '10.1186/s12903-019-0925-z', 'article-title': 'Prevalence of periodontitis and alveolar bone loss in a patient ' 'population at Harvard School of Dental Medicine.', 'volume': '19', 'author': 'Helmi', 'year': '2019', 'journal-title': 'BMC Oral Health'}, { 'key': 'R28-20230928', 'doi-asserted-by': 'crossref', 'first-page': '27', 'DOI': '10.21815/JDE.019.162', 'article-title': 'Dental students’ knowledge and attitudes about electronic cigarettes: a ' 'cross-sectional study at one Saudi University.', 'volume': '84', 'author': 'Natto', 'year': '2020', 'journal-title': 'J Dent Educ'}, { 'key': 'R29-20230928', 'doi-asserted-by': 'crossref', 'DOI': '10.1111/omi.12362', 'article-title': 'Can periodontal pockets and caries lesions act as reservoirs for ' 'Coronavirus?', 'author': 'Natto', 'year': '2022', 'journal-title': 'Mol Oral Microbiol'}, { 'key': 'R30-20230928', 'doi-asserted-by': 'crossref', 'first-page': '9547', 'DOI': '10.2147/IJGM.S331611', 'article-title': 'Characteristics of oral manifestations in symptomatic non-hospitalized ' 'COVID-19 patients: a cross-sectional study on a sample of the Saudi ' 'Population.', 'volume': '14', 'author': 'Natto', 'year': '2021', 'journal-title': 'Int J Gen Med'}, { 'key': 'R31-20230928', 'doi-asserted-by': 'crossref', 'first-page': '406', 'DOI': '10.4103/njcp.njcp_259_20', 'article-title': 'Are saudi healthcare students aware of COVID-19, and do they behave ' 'safely during viral outbreaks?', 'volume': '24', 'author': 'Natto', 'year': '2021', 'journal-title': 'Niger J Clin Pract'}, { 'key': 'R32-20230928', 'doi-asserted-by': 'crossref', 'first-page': '315', 'DOI': '10.2147/RMHP.S278394', 'article-title': 'Characteristics of first cases of coronavirus disease 2019 and the ' 'effort to prevent the early spread of COVID-19 in Saudi Arabia.', 'volume': '14', 'author': 'Natto', 'year': '2021', 'journal-title': 'Risk Manag Healthc Policy'}, { 'key': 'R33-20230928', 'doi-asserted-by': 'crossref', 'first-page': '2951', 'DOI': '10.2147/JMDH.S330567', 'article-title': 'Infection control practices at the dental clinics in Jeddah, Saudi ' 'Arabia.', 'volume': '14', 'author': 'Natto', 'year': '2021', 'journal-title': 'J Multidiscip Healthc'}, { 'key': 'R34-20230928', 'doi-asserted-by': 'crossref', 'first-page': '649', 'DOI': '10.1111/jcpe.12722', 'article-title': 'Efficacy of collagen matrix seal and collagen sponge on ridge ' 'preservation in combination with bone allograft: a randomized ' 'controlled clinical trial.', 'volume': '44', 'author': 'Natto', 'year': '2017', 'journal-title': 'J Clin Periodontol'}], 'container-title': 'Medicine', 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'https://journals.lww.com/10.1097/MD.0000000000028925', 'content-type': 'unspecified', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2023, 9, 28]], 'date-time': '2023-09-28T03:29:29Z', 'timestamp': 1695871769000}, 'score': 1, 'resource': {'primary': {'URL': 'https://journals.lww.com/10.1097/MD.0000000000028925'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2022, 7, 29]]}, 'references-count': 33, 'journal-issue': {'issue': '30', 'published-online': {'date-parts': [[2022]]}}, 'URL': 'http://dx.doi.org/10.1097/MD.0000000000028925', 'relation': {}, 'ISSN': ['1536-5964'], 'subject': ['General Medicine'], 'published': {'date-parts': [[2022, 7, 29]]}}