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Potential Role of Oral Rinses Targeting the Viral Lipid Envelope in SARS-CoV-2 Infection

O’Donnell et al., Function, doi:10.1093/function/zqaa002
Jun 2020  
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Review of the mechanisms of action and studies supporting oral rinsing for the prevention of transmission of SARS-CoV-2, including chlorhexidine, cetylpyridinium chloride, hydrogen peroxide, and povidone-iodine.
Reviews covering povidone-iodine for COVID-19 include1-6.
Review covers hydrogen peroxide and povidone-iodine.
O’Donnell et al., 5 Jun 2020, peer-reviewed, 12 authors.
This PaperPovidone-Iod..All
Potential Role of Oral Rinses Targeting the Viral Lipid Envelope in SARS-CoV-2 Infection
Valerie B O’donnell, David Thomas, Richard Stanton, Jean-Yves Maillard, Robert C Murphy, Simon A Jones, Ian Humphreys, Michael J O Wakelam, Christopher Fegan, Matt P Wise, Albert Bosch, Syed A Sattar
Function, doi:10.1093/function/zqaa002
Emerging studies increasingly demonstrate the importance of the throat and salivary glands as sites of virus replication and transmission in early COVID-19 disease. SARS-CoV-2 is an enveloped virus, characterized by an outer lipid membrane derived from the host cell from which it buds. While it is highly sensitive to agents that disrupt lipid biomembranes, there has been no discussion about the potential role of oral rinsing in preventing transmission. Here, we review known mechanisms of viral lipid membrane disruption by widely available dental mouthwash components that include ethanol, chlorhexidine, cetylpyridinium chloride, hydrogen peroxide, and povidone-iodine. We also assess existing formulations for their potential ability to disrupt the SARS-CoV-2 lipid envelope, based on their concentrations of these agents, and conclude that several deserve clinical evaluation. We highlight that already published research on other enveloped viruses, including coronaviruses, directly supports the idea that oral rinsing should be considered as a potential way to reduce transmission of SARS-CoV-2. Research to test this could include evaluating existing or specifically tailored new formulations in well-designed viral inactivation assays, then in clinical trials. Population-based interventions could be undertaken with available mouthwashes, with active monitoring of outcome to determine efficacy. This is an under-researched area of major clinical need.
Conflict of interest statement None declared.
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Research to test this could include ' 'evaluating existing or specifically tailored new formulations in well-designed viral ' 'inactivation assays, then in clinical trials. Population-based interventions could be ' 'undertaken with available mouthwashes, with active monitoring of outcome to determine ' 'efficacy. 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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. FLCCC and WCH provide treatment protocols.
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