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PVP-I for COVID-19
21 studies with >2,000 patients
Serious outcome risk
Povidone-Iodine
Control
Significantly lower risk for mortality, hospitalization, recovery, cases, and viral clearance.
53% lower risk in 18 RCTs CI 38-65%
88% lower mortality in 1 studies CI 50-97%
COVID-19 PVP-I studies · October 2026
Excessive use of PVP-I could affect thyroid function. Recent:
Singh
Widyarman
Hup.
Covid Analysis Povidone-Iodine reduces COVID-19 risk: real-time meta-analysis of 21 studies (Version 40)
Significantly lower risk is seen for mortality, hospitalization, recovery, cases, and viral clearance. 11 studies from 11 independent teams in 9 countries show significant benefit. Meta-analysis using the most serious outcome reported sho..
Jun 4
 Singh et al., International Journal of Drug Delivery Technology, doi:10.25258/ijddt.16.46s.21 Changes in Thyroid Function Parameters during Short-Term LowConcentration Povidone–Iodine Gargling in Young Adults with Asymptomatic SARS-CoV-2 Infection: A Single-Arm Prospective Cohort Study
Prospective study of 45 young adults with asymptomatic SARS-CoV-2 infection showing no clinically significant thyroid dysfunction with short-term low-concentration povidone-iodine gargling.
Apr 30
 Widyarman et al., Archives of Oral Biology, doi:10.1016/j.archoralbio.2026.106524 Mouthrinses differentially rewire salivary virus-microbiome interaction dynamics in COVID-19 patients: A randomized controlled trial
RCT 40 COVID-19 outpatients showing lower salivary SARS-CoV-2 viral load with cetylpyridinium chloride (CPC), povidone-iodine (PVP-I), and sodium chlorite (NaClO2) mouthrinses, without statistical significance. CPC and PVP-I selectively a..
Feb 27
 Hup et al., Medical Science Monitor, doi:10.12659/MSM.950753 Efficacy of Mouthwashes Delivered via Dental Unit Waterlines in Reducing Aerosolized Surrogate SARS-CoV-2
In vitro study testing mouthwashes delivered through dental unit waterlines for reducing aerosolized surrogate SARS-CoV-2 (human coronavirus OC43). The study used suspension tests, carrier tests, and a novel 3D-printed aerosol model to ev..
Aug 8
2025
 Angjelova et al., Antibiotics, doi:10.3390/antibiotics14080815 Effects of Antiseptic Formulations on Oral Microbiota and Related Systemic Diseases: A Scoping Review
Review of oral antiseptic formulations and their effects on oral microbiota and systemic diseases. While antiseptics like chlorhexidine, essential oils, povidone-iodine, and cetylpyridinium chloride can effectively reduce pathogenic oral..
Jun 18
2025
 Thangamani et al., World Academy of Sciences Journal, doi:10.3892/wasj.2025.366 Rinsing away the threat: Antiviral mouthwashes and their efficacy
Review of antiviral mouthwashes and their efficacy against respiratory viruses, focusing on SARS-CoV-2. Authors examine povidone-iodine (PVP-I), cetylpyridinium chloride (CPC), chlorhexidine (CHX), and phthalocyanine derivatives. PVP-I sh..
Jun 10
2025
 Seijas-Otero et al., Japanese Dental Science Review, doi:10.1016/j.jdsr.2025.05.001 Antiseptics as effective virucidal agents against SARS-CoV-2: Systematic review and Bayesian network meta-analysis
Bayesian network meta-analysis of 26 studies evaluating the effectiveness of oral and nasal antiseptics against SARS-CoV-2 viral load, finding that povidone-iodine was the most effective. Hydrogen peroxide and chlorhexidine also showed si..
Jun 5
2025
 Polasek et al., Frontiers in Medicine, doi:10.3389/fmed.2025.1565069 Povidone-iodine nasal spray (Nasodine®) for the common cold: a randomized, controlled, double-blind, Phase III clinical trial
Non-COVID-19 RCT of 260 outpatients with early common-cold symptoms comparing 0.5% povidone-iodine (PVP-I) nasal spray and saline spray four-times daily for five days. PVP-I showed lower Global Severity Score (GSS) and improved quality-of..
May 31
2025
 Gunawan et al., Journal of International Society of Preventive and Community Dentistry, doi:10.4103/jispcd.jispcd_78_24 The Role of Poly Vinyl Pyrrolidone Iodine (PVP-I) in Preventing Cross-Infection during Dental Procedures: A Systematic Review in the COVID-19 Context
Review of PVP-I for preventing SARS-CoV-2 cross-infection during dental procedures. Authors examined 11 studies (7 in vitro, 4 in vivo), finding that PVP-I was superior to other agents, with concentrations of 0.2% and 0.5% significantly r..
Apr 30
2025
 Sulistyani et al., Dental and Medical Problems, doi:10.17219/dmp/192493 Effects of chlorhexidine gluconate and povidone-iodine mouthwash on cycle threshold values in patients infected with SARS-CoV-2
44% improved viral clearance (p=0.001). Prospective study of 45 COVID-19 patients showing improved viral clearance with chlorhexidine gluconate and povidone-iodine mouthwash use.
Dec 9
2024
 Graves et al., JDR Clinical & Translational Research, doi:10.1177/23800844241296840 A Cetylpyridinium Chloride Oral Rinse Reduces Salivary Viral Load in Randomized Controlled Trials
85% improved viral clearance (p=0.65). Two RCTs with a total of 247 recently diagnosed COVID-19 patients showing a significant reduction in salivary SARS-CoV-2 viral load 30 minutes after rinsing with a cetylpyridinium chloride (CPC) mouthwash compared to rinsing with saline o..
Oct 21
2024
 Okeke et al., Current Research in Microbial Sciences, doi:10.1016/j.crmicr.2024.100293 Antiseptics: An expeditious third force in the prevention and management of coronavirus diseases
Review of the use of nasopharyngeal/oropharyngeal virucidal agents such as povidone-iodine, chlorhexidine, cetylpyridinium chloride, hydrogen peroxide, and others for preventing the spread of COVID-19 and other coronavirus diseases. Autho..
Sep 13
2024
 Gandhi et al., The Laryngoscope, doi:10.1002/lary.31761 Washing Illness Away: A Systematic Review of the Impact of Nasal Irrigation and Spray on COVID‐19
Review of the efficacy of nasal irrigation with saline, povidone-iodine (PVP-I), and intranasal corticosteroids (INCS) at reducing SARS-CoV-2 nasopharyngeal viral load (NVL) and transmissibility. Saline nasal irrigation (SNI) showed the g..
May 16
2024
 Huang et al., Journal of Dentistry, doi:10.1016/j.jdent.2024.105082 Satisfaction with Government Recommended Pre-Procedural Mouth Rinses in the Mitigation of Covid-19 in Hong Kong SAR: A Triple Blind Randomized Controlled Clinical Trial
RCT 228 dental patients showing high satisfaction and acceptability of three pre-procedural mouthrinses (povidone-iodine, hydrogen peroxide, and chlorhexidine digluconate) recommended by the Hong Kong government for mitigating COVID-19 tr..
Mar 30
2024
 Friedland et al., The Laryngoscope, doi:10.1002/lary.31430 Phase II Trial of the Impact 0.5% Povidone‐Iodine Nasal Spray (Nasodine®) on Shedding of SARS‐CoV‐2
60% improved viral clearance (p=0.03) and 6% improved recovery. RCT 23 early COVID-19 outpatients showing significantly improved reduction in viral load and significantly faster viral clearance with povidone-iodine nasal spray compared to placebo. The study was underpowered due to low recruitment, enr..
Mar 22
2024
 Miranda-Massari et al., Revista CISTEI Iodine Oropharyngeal Solution for COVID19: A Cohort Study
Report on 160 COVID-19 patients showing 67% faster recovery with the addition of an iodine nasal and oral spray to the treatment protocol, compared with over 700 patients treated prior to the addition. In a separate cohort of 56 people, a..
Feb 19
2024
 Brito-Reia et al., Current Oral Health Reports, doi:10.1007/s40496-024-00368-1 Antiviral Mechanism and Clinical Benefits of Mouthwash Active Against SARS-CoV-2
Review of antiviral mechanisms and clinical benefits of mouthwashes for SARS-CoV-2, including chlorhexidine (CHX), cetylpyridinium chloride (CPC), ethyl lauroyl arginate (ELA), hydrogen peroxide (HP), povidone-iodine (PVP-I), and anionic..
Dec 31
2023
 Nazrine et al., Journal of Indian Society of Periodontology, doi:10.4103/jisp.jisp_469_22 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
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 ..
Dec 15
2023
 Donzelli, A., MDPI AG, doi:10.20944/preprints202312.1178.v1 Neglected Effective Early Therapies against COVID-19: Focus on Functional Foods and Related Active Substances. A Review
Review of a group of compounds with efficacy shown in RCTs, safety, favorable opportunity costs, biological plausibility, and accessibility without major conflicts of interest. The compounds include curcumin, nigella sativa (black seed), ..
Dec 6
2023
 Alsaleh et al., BMC Infectious Diseases, doi:10.1186/s12879-024-09137-y (date from preprint) Efficacy of povidone-iodine nasal rinse and mouth wash in COVID-19 management: a prospective, randomized pilot clinical trial (povidone-iodine in COVID-19 management)
16% improved recovery (p=0.76) and 73% improved viral clearance (p=0.72). Tiny RCT with 5 PVP-I patients, 6 saline patients, and 8 control patients, showing improved viral clearance with 0.23% povidone-iodine (PVP-I) nasal rinses and mouthwashes. No significant differences were found for viral load by PCR cycle..
Nov 30
2023
 Brookes et al., International Dental Journal, doi:10.1016/j.identj.2023.08.010 Mouthwash Effects on the Oral Microbiome: Are They Good, Bad, or Balanced?
Review of the effects of commonly used mouthwashes on the oral microbiome, which includes bacteria, viruses, bacteriophages, and fungi. While certain mouthwashes have proven antimicrobial actions and clinical effectiveness, more recent me..
Oct 11
2023
 Sbricoli et al., Japanese Dental Science Review, doi:10.1016/j.jdsr.2023.09.003 Efficacy of different mouthwashes against COVID-19: A systematic review and network meta-analysis
Systematic review and network meta-analysis evaluating the effectiveness of antiseptic mouthwashes in reducing SARS-CoV-2 viral load in saliva based on data from 14 randomized clinical trials and 21 in vitro studies. The study found that ..
Oct 11
2023
 Zhang et al., BMC Infectious Diseases, doi:10.1186/s12879-023-08669-z Efficacy of mouthwash on reducing salivary SARS-CoV-2 viral load and clinical symptoms: a systematic review and meta-analysis
Systematic review and meta-analysis of 13 randomized controlled trials with a total of 832 participants analyzing the efficacy of mouthwash on reducing salivary SARS-CoV-2 viral load and clinical symptoms in COVID-19 patients. Authors fou..
Jun 12
2023
 Ting et al., Biomedicines, doi:10.3390/biomedicines11061694 Preprocedural Viral Load Effects of Oral Antiseptics on SARS-CoV-2 in Patients with COVID-19: A Systematic Review
Systematic review of 14 RCTs, showing significant reductions in short-term viral load with mouth rinses cetylpyridinium chloride, β-cyclodextrin and citrox, hydrogen peroxide, chlorhexidine, povidone-iodine, hypochlorous acid, saline, and..
Feb 27
2023
 Chavda et al., Pharmacological Reports, doi:10.1007/s43440-023-00463-7 Nasal sprays for treating COVID-19: a scientific note
Review of nasal sprays for treatment of COVID-19. Authors note that the nasal epithelium is typically the primary site of SARS-CoV-2 infection, and there may be significant advantages for treatments via the nasal route.
Dec 1
2022
 Tsai et al., Frontiers in Medicine, doi:10.3389/fmed.2022.1033601 Iodine contrast exposure and incident COVID-19 infection
24% fewer cases (p<0.0001). Retrospective 530,942 COVID-19 tests in the USA, showing lower incidence of cases with exposure to iodine contrast for imaging within the last 60 days.
Nov 28
2022
 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
2022
 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
2022
 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 load (p=0.5). RCT 32 patients in India, showing greater reduction in viral load with PVP-I treatment, without statistical significance.
Oct 26
2022
 Karaaltin et al., Authorea, doi:10.22541/au.166675335.56566797/v1 Effect of the povidone iodine, hypertonic alkaline solution and saline nasal lavage on nasopharyngeal viral load in COVID-19
83% improved viral load (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. [Kreutzberger] show that SARS-CoV-2 requires acidic pH to infect cel..
Oct 12
2022
 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 model
Animal study showing povidone-iodine effective in reducing influenza A transmission.
Sep 30
2022
 Kreutzberger et al., Proceedings of the National Academy of Sciences, doi:10.1073/pnas.2209514119 SARS-CoV-2 requires acidic pH to infect cells
Real-time 3D single-virion tracking study showing that SARS-CoV-2 infection requires an acidic pH. Authors find the mean pH of the airway-facing surface of the nasal cavity to be 6.6, compatible with fusion. These results suggest a benefi..
Sep 25
2022
 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
2022
 Hasan et al., European Journal of Dentistry, doi:10.1055/s-0042-1753470 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 25
2022
 Baxter et al., Ear, Nose & Throat Journal, doi:10.1177/01455613221123737 Rapid initiation of nasal saline irrigation to reduce severity in high-risk COVID+ outpatients
57% improved recovery (p=0.03) and 14% lower transmission (p=1). Small RCT 79 PCR+ patients 55+ comparing pressure-based nasal irrigation with povidone-iodine and sodium bicarbonate, showing improved recovery with povidone-iodine. Not all results comparing povidone-iodine and sodium bicarbonate are in ..
Aug 22
2022
 Sirijatuphat et al., medRxiv, doi:10.1101/2022.08.18.22278340 A pilot study of 0.4% povidone-iodine nasal spray to eradicate SARS-CoV-2 in the nasopharynx
33% improved viral load (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 31
2022
 Khan et al., Trials, doi:10.1186/s13063-020-04634-2 A quadruple blind, randomised controlled trial of gargling agents in reducing intraoral viral load among hospitalised COVID-19 patients: A structured summary of a study protocol for a randomised controlled trial
Estimated 50 patient povidone-iodine early treatment RCT with results not reported over 4 years after estimated completion.
Jul 31
2022
 Ting et al., International Journal of Translational Medicine, doi:10.3390/ijtm2030030 The In Vitro Virucidal Effects of Mouthwashes on SARS-CoV-2
Review of in vitro studies of mouthwashes, showing antiviral activity for SARS-CoV-2 with many compounds including PVP-I, cetylpyridinium chloride, chlorohexidine gluconate, dequalinium chloride, benzalkonium chloride, anionic phthalocyan..
Jul 29
2022
 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
2022
 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, 20 HOCl, and 20 saline patients gargling for 30 seconds and testing PCR Ct after 30 minutes, showing greater improvement with PVP-I and HOCl, without statistical significance. Ct values differ across testing platforms, ..
Jul 28
2022
 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
2022
 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..
Jul 21
2022
 Ghasemi et al., Eur. J. Gen. Dent., doi:10.1055/s-0042-1747958 Reduction in SARS-CoV-2 Oral Viral Load with Prophylactic Mouth Rinse
RCT 116 patients in Iran, showing lower short term viral load with mouth rinses chlorhexidine, hydrogen peroxide, and povidone-iodine. Chlorhexidine and hydrogen peroxide were the most effective.
Jun 30
2022
 Keating et al., NCT04478019 SHIELD Study: Using Naso-oropharyngeal Antiseptic Decolonization to Reduce COVID-19 Viral Shedding (SHIELD)
245 participant povidone-iodine + chlorhexidine prophylaxis RCT with results not reported over 4 years after completion.
Jun 30
2022
 Saud et al., Journal of Lipid Research, doi:10.1016/j.jlr.2022.100208 The SARS-CoV2 envelope differs from host cells, exposes procoagulant lipids, and is disrupted in vivo by oral rinses
In vitro study and small RCT of mouthwashes. The in vitro study characterized the lipid composition of the SARS-CoV-2 envelope and showed that oral rinses containing lipid-disrupting chemicals can reduce infectivity, meeting European viru..
May 20
2022
 Lim et al., Annals of Medicine, doi:10.1080/07853890.2022.2076902 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
2022
 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, 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, and sign..
Mar 15
2022
 Sulistyani et al., F1000Research, doi:10.12688/f1000research.110843.1 (date from 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
2022
 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 28
2022
 Akash et al., Frontiers in Drug Delivery, doi:10.3389/fddev.2023.1164671 (date from preprint) On a model-based approach to improve intranasal spray targeting for respiratory viral infections
Computational fluid dynamics study of nasal spray administration in 2 subjects showing 100x improvement in nasopharyngeal drug delivery using a new spray placement protocol. The study also found the optimal droplet size range for nasophar..
Jan 15
2022
 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 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 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.
Jul 9
2021
 Köntös, Z., PLOS ONE, doi:10.1371/journal.pone.0254341 Efficacy of “Essential Iodine Drops” against Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV-2)
In vitro study showing 99% lower viral titer after 90 seconds with Essential Iodine Drops (EID), a formulation of Iodine-V. Author notes a potential safety advantage compared with PVP-I.
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.
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 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 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 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 Povidone iodine, hydrogen peroxide and chlorhexidine mouthwashes reduce SARS-CoV2 burden in whole mouth fluid and respiratory droplets
Study of SARS-CoV-2 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 significa..
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 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 load (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, doi:10.3329/brc.v7i1.54245 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 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 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 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 29
2020
 Meister et al., The Journal of Infectious Diseases, doi:10.1093/infdis/jiaa471 Virucidal Efficacy of Different Oral Rinses Against Severe Acute Respiratory Syndrome Coronavirus 2
In vitro analysis of 8 oral rinses, showing reduced viral infectivity up to 3 orders of magnitude with povidone-iodine, ethanol + essential oils, and dequalinium chloride + benzalkonium chloride, and log reduction factors ranging from 0.3..
Jul 8
2020
 Anderson et al., Infectious Diseases and Therapy, doi:10.1007/s40121-020-00316-3 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: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 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 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 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 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.