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In vivo efficacy of 2% povidone iodine, chlorhexidine gluconate, and herbal extract mouthwash on SARS-CoV-2 viral load in saliva: A randomized clinical trial

Nazrine et al., Journal of Indian Society of Periodontology, doi:10.4103/jisp.jisp_469_22
Dec 2023  
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PVP-I for COVID-19
13th treatment shown to reduce risk in February 2021
*, now known with p = 0.000000037 from 20 studies.
Lower risk for mortality, cases, and viral clearance.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
3,900+ studies for 60+ treatments.
Randomized trial of 30 COVID-19 patients in India, comparing povidone-iodine (PVP-I), chlorhexidine gluconate (CHX), and herbal extract mouthwash for reducing SARS-CoV-2 viral load in saliva after a 30 second rinse. All treatments showed an increase in PCR cycle threshold values at 30 minutes, suggesting reduced viral load, however the difference was only statistically significant for PVP-I.
Study covers chlorhexidine and povidone-iodine.
Nazrine et al., 31 Dec 2023, prospective, India, peer-reviewed, 4 authors, study period December 2021 - February 2022.
This PaperPovidone-Iod..All
In vivo efficacy of 2% povidone iodine, chlorhexidine gluconate, and herbal extract mouthwash on SARS-CoV-2 viral load in saliva: A randomized clinical trial
Dr Sayana Nazrine, Ritesh Kulal, B M Shivaprasad, Nimmi Janardhanan
Journal of Indian Society of Periodontology, doi:10.4103/jisp.jisp_469_22
Background: One of the major techniques to reduce the transmission rate of COVID-19 would be to decrease the viral titers of SARS-CoV-2 in the saliva of infected patients and it is particularly useful in a dental setting. The present study evaluated the change in salivary viral load of COVID-19 patients using povidone iodine (PI), chlorhexidine (CHX), and an herbal extract (RightSure ® ) oral antiviral herbal mouthwash (HM) at clinically recommended duration and concentrations. Materials and Methods: Thirty individuals with SARS-CoV-2 were randomly allocated to three groups: (1) Group 1, PI mouthwash; (2) Group 2, CHX mouthwash; and (3) Group 3, HM mouthwash. A baseline salivary throat sample was collected from all the participants who were later instructed to rinse with their respective mouthwash for 30 s. A second salivary sample was collected 30 min after rinsing. The SARS-CoV-2 viral load was analyzed using real-time reverse-transcription polymerase chain reaction wherein the cyclic threshold (Ct) values were evaluated. Results: Independent t-test analysis reported a statistically significant difference concerning the PI group (before-after comparison) (P < 0.05). The rest of the two study groups failed to report any significant difference in the nucleocapsid gene and open reading frame 1a gene levels. Conclusion: While all three types of mouthwash increased the Ct values, a statistically significant difference was observed with PI mouthwash, indicating that it might potentially reduce the spread of the SARS-CoV-2 virus, especially via aerosol but further studies with larger sample size and longer follow-up periods are required to investigate this relationship.
Conflicts of interest There are no conflicts of interest.
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