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PVP-I for COVID-19
20 studies from 191 scientists
3,226 patients in 15 countries
Statistically significant improvement for mortality, hospitalization, cases, and viral clearance.
10 studies from 10 independent teams in 8 countries show statistically significant improvements.
53% improvement in 17 RCTs CI [36-66%]
72% lower mortality in 2 studies CI [8-92%]
COVID-19 PVP-I studies. Dec 2022. c19early.org/p
0 0.5 1 1.5+ All studies 51% With exclusions 52% Mortality 72% Hospitalization 84% Recovery 25% Cases 45% Viral clearance 65% RCTs 53% RCT mortality 88% Prophylaxis 45% Early 65% Late 42% Favorspovidone-iodine Favorscontrol
Povidone-Iodine COVID-19 studies. Some studies only test short term viral load after a single application. Excessive use of PVP-I could affect thyroid function. Recent:
Matsuyama
Quek
Sulistyani
Sharma
Karaaltin
Gaaloul ben Hnia
Idrees.
Submit updates/corrections.
Dec 2
Covid Analysis (Preprint) (meta analysis) Povidone-Iodine for COVID-19: real-time meta analysis of 20 studies
Statistically significant improvements are seen for mortality, hospitalization, cases, and viral clearance. 10 studies from 10 independent teams in 8 different countries show statistically significant improvements in isolation (7 for th..
Nov 28
Matsuyama et al., Scientific Reports, doi:10.1038/s41598-022-24683-8 A prospective, randomized, open-label trial of early versus late povidone-iodine gargling in patients with COVID-19
69% improved viral clearance [p=0.03]. RCT 430 COVID+ patients in Japan, showing significantly lower viral infectivity from culture, and significantly faster PCR viral clearance with PVP-I. For days 2-4 the study compares treatment with PVP-I vs. water (on day 5 both groups re..
Nov 18
Quek et al., Annals of Medicine, doi:10.1080/07853890.2022.2108132 Stable thyroid function despite regular use of povidone-iodine throat spray for SARS-CoV-2 prophylaxis
Safety analysis of 42 day treatment with a povidone-iodine throat spray in 117 patients compared with 60 controls, showing no significant differences in thyroid function. Authors note the study included relatively young and healthy patien..
Oct 31
Sharma et al., Journal of Family Medicine and Primary Care, doi:10.4103/jfmpc.jfmpc_446_22 Effect of 0.5% povidone-iodine on the nasopharyngeal and oropharyngeal viral loads in patients with COVID-19: A double-blind placebo-controlled randomized clinical trial
100% improved viral clearance [p=0.5]. RCT 32 patients in India, showing greater reduction in viral load with PVP-I treatment, without statistical significance.
Oct 26
Karaaltin et al., Authorea, Inc., doi:10.22541/au.166675335.56566797/v1 (Preprint) Effect of the povidone iodine, hypertonic alkaline solution and saline nasal lavage on nasopharyngeal viral load in COVID-19
83% improved viral clearance [p=0.007]. RCT 120 outpatients in Turkey, showing improved reduction in viral load with PVP-I nasal irrigation. PVP-I prepared with hypertonic alkaline solution had better results, consistent with [Kreutzberger], showing that SARS-CoV-2 requires aci..
Oct 12
Gaaloul ben Hnia et al., Influenza and Other Respiratory Viruses, doi:10.1111/irv.13035 Intranasal antisepsis to reduce influenza virus transmission in an animal modelhttps://onlinelibrary.wiley.com/doi/10.1111/irv.13035
Animal study showing povidone-iodine effective in reducing influenza A transmission.
Sep 25
Idrees et al., International Journal of Environmental Research and Public Health, doi:10.3390/ijerph191912148 Efficacy of Mouth Rinses and Nasal Spray in the Inactivation of SARS-CoV-2: A Systematic Review and Meta-Analysis of In Vitro and In Vivo Studies
Systematic review and meta analysis showing significant reduction in SARS-CoV-2 salivary viral load with povidone-iodine and chlorhexidine.
Sep 8
Hasan et al., European Journal of Dentistry, doi:10.1055/s-0042-1753470 (meta analysis) Effects of Chlorhexidine and Povidone-Iodine on the SARS-CoV-2 Load: A Systematic Review and Meta-analysis
Systematic review and meta analysis showing significantly improved viral clearance with both povidone-iodine and chlorhexidine.
Aug 22
Sirijatuphat et al., medRxiv, doi:10.1101/2022.08.18.22278340 (Preprint) A pilot study of 0.4% povidone-iodine nasal spray to eradicate SARS-CoV-2 in the nasopharynx
33% improved viral clearance [p=0.58]. Small single-arm trial testing short-term viral load change after a single administration of three puffs of 0.4% PVP-I, showing lower viral titer at 3 minutes and 4 hours, not reaching statistical significance. Authors note that one reaso..
Jul 29
Natto et al., Medicine, doi:10.1097/MD.0000000000028925 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
74% improved viral load [p=0.27]. 60 patient RCT comparing chlorhexidine, PVP-I, and saline in Saudi Arabia with a single mouth rinse treatment and PCR testing 5 minutes later, showing statistically significant improvement in Ct value for PVP-I. PVP-I showed greater impro..
Jul 29
Sevinç Gül et al., Dental and Medical Problems, doi:10.17219/dmp/150831 Effect of oral antiseptics on the viral load of SARS-CoV-2: A randomized controlled trial
RCT with 21 PVP-I and 20 saline patients gargling for 30 seconds and testing PCR Ct after 30 minutes, showing greater improvement with PVP-I, without statistical significance. Ct values differ across testing platforms, however the reporte..
Jul 28
Fantozzi et al., American Journal of Otolaryngology, doi:10.1016/j.amjoto.2022.103549 Efficacy of antiseptic mouthrinses against SARS-CoV-2: A prospective randomized placebo-controlled pilot study
57% improved viral load and 31% improved viral clearance [p=0.26]. Mouthrinse RCT in Italy comparing short-term viral load after a single 60 second treatment with povidone-iodine, hydrogen peroxide, chlorhexidine, and saline. The greatest efficacy was seen with povidone-iodine, especially for patients wi..
Jul 27
Sánchez Barrueco et al., Emerging Microbes & Infections, doi:10.1080/22221751.2022.2098059 Effect of oral antiseptics in reducing SARS-CoV-2 infectivity: evidence from a randomized double-blind clinical trial
34% improved viral load. RCT hospitalized patients testing viral load shortly after a single mouthwash with PVP-I, hydrogen peroxide, cetylpyridinium chloride, chlorhexidine, and water. For PVP-I, there were only 5 patients with viable virus at baseline. Cross-tr..
May 20
Lim et al., Annals of Medicine, doi:10.1080/07853890.2022.2076902 (Review) Repurposing povidone-iodine to reduce the risk of SARS-CoV-2 infection and transmission: a narrative review
Review of in vitro, animal, and clinical studies supporting the use of povidone-iodine for SARS-CoV-2.
Apr 19
Elsersy et al., Frontiers in Medicine, doi:10.3389/fmed.2022.863917 Combined Nasal, Oropharyngeal Povidone Iodine Plus Glycyrrhizic Acid Sprays, Accelerate Clinical and Laboratory Recovery and Reduces Household Transmission of SARS-CoV-2: A Randomized Placebo-Controlled Clinical Trial
91% lower hospitalization [p=0.06], 15% faster recovery [p=0.008], 68% improved viral clearance [p<0.0001], and 92% lower transmission [p<0.0001]. RCT with 200 patients and 421 contacts in Egypt, with 100 patients and their contacts treated with nasal and oropharyngeal sprays containing povidone-iodine and glycyrrhizic acid, showing significantly faster viral clearance and recovery,..
Mar 15
Sulistyani et al., F1000Research, doi:10.12688/f1000research.110843.1 (date from earlier preprint) The effects of mouth rinsing and gargling with mouthwash containing povidone-iodine and hydrogen peroxide on the cycle threshold value of Severe Acute Respiratory Syndrome Coronavirus 2: A randomized controlled trial of asymptomatic and mildly symptomatic patients
6% improved viral clearance [p=0.74]. Small mouth rinsing and gargling RCT with 15 1% PVP-I, 12 0.5% PVP-I, 15 3% hydrogen peroxide, 12 1.5% hydrogen peroxide, and 15 water patients, showing rapid improvement in Ct value in all groups, and no significant differences between g..
Feb 9
Friedland et al., Australian Journal of Otolaryngology, doi:10.21037/ajo-21-40 In vivo (human) and in vitro inactivation of SARS-CoV-2 with 0.5% povidone-iodine nasal spray
Small study of povidone-iodine nasal spray with 14 patients, showing rapid reduction in viral load for the 6 patients that had culturable virus at baseline. All patients remained PCR+ despite no culturable virus detected for 3 of 6 patien..
Jan 15
Seikai et al., Journal of Hospital Infection, doi:10.1016/j.jhin.2022.01.001 Gargling with povidone iodine has a short-term inhibitory effect on SARS-Cov-2 in COVID-19 patients
Small study of 11 patients showing a rapid short-term decrease of viral load in saliva samples with povidone-iodine.
Dec 22
2021
Ferrer et al., Scientific Reports, doi:10.1038/s41598-021-03461-y Clinical evaluation of antiseptic mouth rinses to reduce salivary load of SARS-CoV-2
34% improved viral load [p=0.82]. Small very late (>50% 7+ days from symptom onset, 9 PVP-I patients) RCT testing mouthwashing with cetylpyridinium chloride, chlorhexidine, povidone-iodine, hydrogen peroxide, and distilled water, showing no significant differences. Over 3..
Dec 13
2021
Jamir et al., Cureus, doi:10.7759/cureus.20394 Determinants of Outcome Among Critically Ill Police Personnel With COVID-19: A Retrospective Observational Study From Andhra Pradesh, India
57% lower mortality [p=0.0004]. Retrospective 266 COVID-19 ICU patients in India, showing significantly lower mortality with PVP-I oral gargling and topical nasal use, and non-statistically significant higher mortality with ivermectin and lower mortality with remdesivir.
Nov 24
2021
Sudhakar et al., World Journal of Dentistry, doi:10.5005/jp-journals-10015-1868 (meta analysis) In Vivo Efficacy of Povidone-iodine Mouth Gargles in Reducing Salivary Viral Load in COVID-19 Patients: A Systematic Review
Systematic review of the use of povidone-iodine gargles for COVID-19, concluding that PVP-I effectively reduces SARS-CoV-2 viral load.
Nov 1
2021
Zarabanda et al., Laryngoscope, doi:10.1002/lary.29935 The Effect of Povidone-Iodine Nasal Spray on COVID-19 Nasopharyngeal Viral Load in Patients: A Randomized Control Trial
27% worse recovery [p=1] and no change in viral clearance [p=1]. Very late treatment (7 days from onset) RCT comparing 11 & 13 PVP-I (0.5% and 2%), and 11 saline spray patients in the USA, showing no significant differences. There was no control group (saline is likely not a placebo, showing efficacy i..
Oct 25
2021
Pablo-Marcos et al., Enfermedades Infecciosas y Microbiología Clínica, doi:10.1016/j.eimc.2021.10.005 Utility of mouth rinses with povidone-iodine and hydrogen peroxide in patients with COVID-19
29% improved viral clearance [p=0.4]. Small prospective study with 31 patients gargling povidone-iodine, 17 hydrogen peroxide, and 40 control patients, showing lower viral load mid-recovery with povidone-iodine, without reaching statistical significance. Oropharyngeal only, a..
Oct 3
2021
Frank et al., Otolaryngology - Head and Neck Surgery, 165:89 (Preprint) Tolerance of nasal and oral povidone-iodine antisepsis amid COVID-19 pandemic
Prospective study of 42 otolaryngology and dental patients, showing low-dose nasal and oral PVP-I solutions to be well-tolerated.
Aug 17
2021
Baxter et al., medRxiv, doi:10.1101/2021.08.16.21262044 (Preprint) Rapid initiation of nasal saline irrigation: hospitalizations in COVID-19 patients randomized to alkalinization or povidone-iodine compared to a national dataset
57% improved recovery [p=0.03] and 37% lower transmission [p=0.51]. Small RCT 79 PCR+ patients 55+ comparing pressure-based nasal irrigation with povidone-iodine and sodium bicarbonate, showing improved recovery with povidone-iodine, and 0/37 COVID-19 related hospitalizations for povidone-iodine compared ..
Jun 11
2021
Chaudhary et al., The Journal of the American Dental Association, doi:10.1016/j.adaj.2021.05.021 Estimating salivary carriage of severe acute respiratory syndrome coronavirus 2 in nonsymptomatic people and efficacy of mouthrinse in reducing viral load
Small RCT comparing mouthrinsing with saline, 1% hydrogen peroxide, 0.12% chlorhexidine, and 0.5% povidone-iodine, showing significant reductions in salivary viral load for all 4 mouthrinses at 15 and 45 minutes after rinsing. NCT04603794.
May 18
2021
Arefin et al., Indian Journal of Otolaryngology and Head & Neck Surgery, doi:10.1007/s12070-021-02616-7 Virucidal effect of povidone iodine on COVID-19 in the nasopharynx: an open-label randomized clinical trial
79% improved viral clearance [p=0.02]. RCT with 189 patients showing significantly greater viral clearance with a single application of PVP-I. Authors recommend using PVP-I prophylactically in the nasopharynx and oropharynx. NCT04549376 [trialsjournal.biomedcentral.com].
Apr 14
2021
Seet et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2021.04.035 Positive impact of oral hydroxychloroquine and povidone-iodine throat spray for COVID-19 prophylaxis: an open-label randomized trial
45% fewer symptomatic cases [p=0.002] and 31% fewer cases [p=0.01]. Prophylaxis RCT in Singapore with 3,037 low risk patients, showing lower serious cases, lower symptomatic cases, and lower confirmed cases of COVID-19 with all treatments (ivermectin, HCQ, PVP-I, and Zinc + vitamin C) compared to vitamin ..
Apr 8
2021
Arefin, M., Indian Journal of Otolaryngology and Head & Neck Surgery, doi:10.1007/s12070-021-02525-9 Povidone Iodine (PVP-I) Oro-Nasal Spray: An Effective Shield for COVID-19 Protection for Health Care Worker (HCW), for all
Report on clinical experience with prophylactic use of PVP-I for COVID-19 in a very high risk environment with no infections, review of the use of PVP-I for the prevention of respiratory infections, and recommendations for use with COVID-..
Mar 17
2021
Elzein et al., Journal of Evidence Based Dental Practice, doi:10.1016/j.jebdp.2021.101584 (date from earlier preprint) In vivo evaluation of the virucidal efficacy of chlorhexidine and povidone-iodine mouthwashes against salivary SARS-CoV-2. A randomized-controlled clinical trial
89% improved viral clearance [p=0.05]. Small RCT comparing mouthwashing with PVP-I, Chlorhexidine, and water, showing significant efficacy for both PVP-I and Chlorhexidine, with PVP-I increasing Ct by a mean of 4.45 (p < 0.0001) and Chlorhexidine by a mean of 5.69 (p < 0.0001)..
Mar 15
2021
Chopra et al., Japanese Dental Science Review, doi:10.1016/j.jdsr.2021.03.001 (Review) 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
Review discussing the rationale, safety, recommendations, and dosage of PVP-I gargle/mouthwash as an effective method to decrease the viral load of SARS-CoV-2.
Mar 1
2021
Xu et al., Pathogens, doi:10.3390/pathogens10030272 (In Vitro) Differential Effects of Antiseptic Mouth Rinses on SARS-CoV-2 Infectivity In Vitro
In Vitro study showing that PVP-I and other mouthwashes inactivated replication-competent SARS-CoV-2.
Mar 1
2021
Jayaraman et al., medRxiv, doi:10.1101/2021.02.25.21252488 (Preprint) Povidone iodine, hydrogen peroxide and chlorhexidine mouthwashes reduce SARS-CoV2 burden in whole mouth fluid and respiratory droplets
Study of SARS-CoV2 burden in whole mouth fluid and respiratory droplets with povidone iodine, hydrogen peroxide, and chlorhexidine mouthwashes in 36 hospitalized COVID-19 patients using PCR and rapid antigen testing. There were significan..
Feb 4
2021
Guenezan et al., JAMA Otolaryngol Head Neck Surg., doi:10.1001/jamaoto.2020.5490 Povidone Iodine Mouthwash, Gargle, and Nasal Spray to Reduce Nasopharyngeal Viral Load in Patients With COVID-19: A Randomized Clinical Trial
63% improved viral load [p=0.25]. RCT of PCR+ patients with Ct<=20 with 12 treatment and 12 control patients, concluding that nasopharyngeal decolonization may reduce the carriage of infectious SARS-CoV-2 in adults with mild to moderate COVID-19. All patients but 1 had ne..
Feb 1
2021
Tucker et al., bioRxiv, doi:10.1101/2021.01.31.426979 (Preprint) (In Vitro) In vitro inactivation of SARS-CoV-2 with 0.5% povidone iodine nasal spray (Nasodine) at clinically relevant concentrations and timeframes using tissue culture and PCR based assays
In Vitro study showing that PVP-I eliminated the viability of SARS-CoV-2 with short exposure times. Authors find that PCR alone may not be adequate for viral quantification and recommend incorporating cell culture to assess viral viability.
Jan 3
2021
Khan et al., American Journal of Otolaryngology, doi:10.1016/j.amjoto.2020.102880 Tolerability and usability of 0.5% PVP-I gargles and nasal drops in 6692 patients: Observational study
Study of the use of PVP-I gargles and nasal drops before and after ENT examinations with a total of 6,692 patients, finding high usability and good tolerance for use. 21 patients (0.76%) reported an itching sensation in the nose on the fi..
Dec 14
2020
Seneviratne et al., Infection, doi:10.1007/s15010-020-01563-9 Efficacy of commercial mouth-rinses on SARS-CoV-2 viral load in saliva: randomized control trial in Singapore
33% improved viral clearance [p=0.01]. Small mouthwash RCT with 4 PVP-I patients and 2 water patients concluding that PVP-I may have a sustained effect on reducing the salivary SARS-CoV-2 level in COVID-19 patients. ISRCTN95933274.
Dec 3
2020
Choudhury et al., Bioresearch Communications, Volume 7, Issue 1, January 2021 Effect of 1% Povidone Iodine Mouthwash/Gargle, Nasal and Eye Drop in COVID-19 patient
88% lower mortality [p=0.0006], 84% lower hospitalization [p<0.0001], and 96% improved viral clearance [p<0.0001]. RCT 606 patients in Bangladesh for povidone iodine mouthwash/gargle, nasal drops and eye drops showing significantly lower death, hospitalization, and PCR+ at day 7.
Sep 21
2020
Pelletier et al., Ear, Nose & Throat Journal, doi:10.1177/0145561320957237 (In Vitro) Efficacy of Povidone-Iodine Nasal and Oral Antiseptic Preparations Against Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV-2)
In Vitro study testing nasal and oral PVP-I formulations with 60 second exposure time, showing complete inactivation of SARS-CoV-2 with all concentrations (1% to 5% PVP-I).
Sep 17
2020
Frank et al., JAMA Otolaryngol Head Neck Surg, doi:10.1001/jamaoto.2020.3053 (In Vitro) In Vitro Efficacy of a Povidone-Iodine Nasal Antiseptic for Rapid Inactivation of SARS-CoV-2
In Vitro study showing povidone-iodine nasal antiseptics at concentrations (0.5%, 1.25%, and 2.5%) completely inactivated SARS-CoV-2 within 15 seconds of contact. No cytotoxic effects on cells were observed after contact with each of the ..
Sep 9
2020
Mohamed et al., medRxiv, doi:10.1101/2020.09.07.20180448 (Preprint) Early viral clearance among COVID-19 patients when gargling with povidone-iodine and essential oils: a pilot clinical trial
86% improved viral clearance [p=0.17]. Tiny RCT with 5 PVP-I patients, gargling 30 seconds, 3x per day, and 5 control patients (essential oils and tap water were also tested), showing improved viral clearance with PVP-I.
Jul 8
2020
Anderson et al., Infectious Diseases and Therapy, doi:10.1007/s40121-020-00316-3 (In Vitro) Povidone-Iodine Demonstrates Rapid In Vitro Virucidal Activity Against SARS-CoV-2, The Virus Causing COVID-19 Disease
In Vitro study showing rapid and effective virucidal activity of PVP-I against SARS-CoV-2. All four products tested [antiseptic solution (PVP-I 10%), skin cleanser (PVP-I 7.5%), gargle and mouth wash (PVP-I 1%) and throat spray (PVP-I 0.4..
Jul 2
2020
Martínez Lamas et al., Oral Diseases, doi:doi.org/10.1111/odi.13526 Is povidone iodine mouthwash effective against SARS‐CoV‐2? First in vivo tests
Small study analyzing the impact of PVP-I mouthwash on the salivary viral load of SARS-CoV-2 in 4 patients with COVID-19. In 2 of the 4 patients (those with a higher initial viral load), PVP-I resulted in a significant drop in viral load,..
Jun 26
2020
Hassandarvish et al., British Dental Journal volume, doi:10.1038/s41415-020-1794-1 (In Vitro) Povidone iodine gargle and mouthwash
In Vitro study showing undiluted PVP-I (1% w/v) achieved >5 log10 reduction in SARS-CoV-2 virus titres at 15, 30 and 60 seconds treatment exposure under both clean and dirty conditions. In contrast, when PVP-I was tested at 1:2 dilution a..
Jun 18
2020
Khan et al., Am J Otolaryngol, doi:10.1016/j.amjoto.2020.102618 Repurposing 0.5% povidone iodine solution in otorhinolaryngology practice in Covid 19 pandemic
Study of the use of PVP-I gargles and nasal drops before ENT appointments finding good tolerability.
Jun 10
2020
Frank et al., Ear, Nose & Throat Journal, doi:10.1177/0145561320932318 Povidone-Iodine Use in Sinonasal and Oral Cavities: A Review of Safety in the COVID-19 Era
Review of povidone-iodine finding that it can safely be used in the nose at concentrations up to 1.25% and in the mouth at concentrations up to 2.5% for up to 5 months.
Jun 8
2020
Bidra et al., Journal of Prosthodontics, doi:10.1111/jopr.13209 (In Vitro) Rapid In-Vitro Inactivation of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Using Povidone-Iodine Oral Antiseptic Rinse
In Vitro study showing PVP-I rapidly inactivated SARS-CoV-2. Viricidal activity was present at the lowest concentration and contact time tested (0.5% PVP-I and 15 seconds).
Jun 5
2020
O’Donnell et al., Function, doi:10.1093/function/zqaa002 (Review) Potential Role of Oral Rinses Targeting the Viral Lipid Envelope in SARS-CoV-2 Infection
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.
May 7
2020
Mendoza et al., SSRN, doi:10.2139/ssrn.3589404 (Preprint) Prevention of COVID-19 Infection with Povidone-Iodine
Review of the antiviral efficacy of PVP-I and its potential use as a prophylactic on the oropharyngeal and nasopharyngeal mucosa for COVID-19.
Please send us corrections, updates, or comments. Vaccines and treatments are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment, vaccine, 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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