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The SARS-CoV2 envelope differs from host cells, exposes procoagulant lipids, and is disrupted in vivo by oral rinses

Saud et al., Journal of Lipid Research, doi:10.1016/j.jlr.2022.100208
Jun 2022  
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PVP-I for COVID-19
13th treatment shown to reduce risk in February 2021
 
*, now with p = 0.000000004 from 21 studies.
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4,400+ studies for 79 treatments. c19early.org
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 virucidal standards. Authors also show that SARS-CoV-2 virions can enhance plasma coagulation, which is related to exposed phosphatidylserine on the viral envelope.
The RCT shows the best results with cetylpyridinium chloride/isopropyl myristate, which eliminated live virus in the oral cavity of COVID-19 patients for one hour in many patients. Reductions in viral load with povidone-iodine and saline were not statistically significant with the small sample size.
Analysis of short-term changes in viral load using PCR may not detect effective treatments because PCR is unable to differentiate between intact infectious virus and non-infectious or destroyed virus particles. For example Tarragó‐Gil, Alemany perform RCTs with cetylpyridinium chloride (CPC) mouthwash that show no difference in PCR viral load, however there was significantly increased detection of SARS-CoV-2 nucleocapsid protein, indicating viral lysis. CPC inactivates SARS-CoV-2 by degrading its membrane, exposing the nucleocapsid of the virus. To better estimate changes in viral load and infectivity, methods like viral culture that can differentiate intact vs. degraded virus are preferred.
Study covers cetylpyridinium chloride and povidone-iodine.
Saud et al., 30 Jun 2022, Randomized Controlled Trial, United Kingdom, peer-reviewed, 26 authors. Contact: stantonrj@cardiff.ac.uk, o-donnellvb@cardiff.ac.uk, thomasdw2@cardiff.ac.uk.
This PaperPovidone-Iod..All
The SARS-CoV2 envelope differs from host cells, exposes procoagulant lipids, and is disrupted in vivo by oral rinses
Zack Saud, Victoria J Tyrrell, Andreas Zaragkoulias, Majd B Protty, Evelina Statkute, Anzelika Rubina, Kirsten Bentley, Daniel A White, Patricia Dos Santos Rodrigues, Robert C Murphy, Harald Köfeler, William J Griffiths, Jorge Alvarez-Jarreta, Richard William Brown, Robert G Newcombe, James Heyman, Manon Pritchard, Robert Wj. Mcleod, Arvind Arya, Ceri-Ann Lynch, David Owens, P Vince Jenkins, Niklaas J Buurma, Valerie B O’donnell, David W Thomas, Richard J Stanton
Journal of Lipid Research, doi:10.1016/j.jlr.2022.100208
The lipid envelope of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an essential component of the virus; however, its molecular composition is undetermined. Addressing this knowledge gap could support the design of antiviral agents as well as further our understanding of viralhost protein interactions, infectivity, pathogenicity, and innate immune system clearance.
Supplemental data This article contains supplemental data. Author contributions Conflict of interest Venture Life Group plc and Johnson & Johnson provided information on mouthwash formulations employed in the in vitro study. Venture Life Group partfunded the clinical study but had no input in study design, data ysis, or drafting of the article. The authors declare that they have no conflicts of interest with the contents of this article. Abbreviations ACE2, angiotensin-converting enzyme 2; aPL, aminophospholipid; CE, cholesteryl ester; Cer, ceramide; cmc, critical micelle concentration; COVID-19, coronavirus disease 2019; CPC, cetylpyridinium chloride; CUR, curtain gas; DHCer, dihydroceramide; ER, endoplasmic reticulum; GS1, source gas 1; GS2, source gas 2; HILIC, hydrophilic interaction liquid chromatography; HSV, herpes simplex virus; IPM, isopropyl myristate; IS, ionization voltage; LAE, ethyl lauroyl arginate; LMSD, LIPID MAPS Structure Database; MRM, multiple reaction monitoring; PC, phosphatidylcholine; PE, phosphatidylethanolamine; PFU, plaque-forming unit; PG, phosphatidylglycerol; PI, phosphatidylinositol; PL, phospholipid; PS, phosphatidylserine; PVP-I, povidoneiodine; SARS-CoV2, severe acute respiratory syndrome coronavirus 2; SEC, size-exclusion chromatography; SL, sphingolipid; TAG, triacylglyceride; TEM, temperature; TG, triglyceride; TMPRSS2, transmembrane serine protease 2.
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Late treatment
is less effective
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