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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

Sulistyani et al., F1000Research, doi:10.12688/f1000research.110843.1 (date from preprint)

Mar 2022

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PVP-I for COVID-19

12th treatment shown to reduce risk in February 2021

^*, now known with p = 0.000000004 from 21 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.

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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 groups.

Targeted administration to the respiratory tract provides treatment directly to the typical source of initial SARS-CoV-2 infection and replication, and allows for rapid onset of action, higher local drug concentration, and reduced systemic side effects.

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relative improvement in Ct value, 6.3% better, RR 0.94, p = 0.74, treatment mean 12.905 (±5.96) n=15, control mean 12.088 (±7.38) n=15, 1% PVP-I vs. water, day 5.

relative improvement in Ct value, 11.3% better, RR 0.89, p = 0.54, treatment mean 13.628 (±6.28) n=15, control mean 12.088 (±7.38) n=15, 0.5% PVP-I vs. water, day 5.

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Sulistyani et al., 15 Mar 2022, Single Blind Randomized Controlled Trial, Indonesia, peer-reviewed, 9 authors, study period July 2021 - September 2021. Contact: liliesdwi_s@yahoo.co.id.

This Paper Povidone-Iod..All

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

Lilies Dwi Sulistyani, Vera Julia, Andrianto Soeprapto, Rumartha Putri Swari, Febriadi Rosmanato, Budi Haryanto, Cahyarini Cahyarini, Rinaldi Panjaitan, Diah Ayu Maharani

F1000Research, doi:10.12688/f1000research.110843.1

Background: Coronavirus disease 2019 can spread rapidly. Surgery in the oral cavity poses a high risk of transmission of severe acute respiratory syndrome coronavirus 2. The American Dental Association and the Centers for Disease Control and Prevention recommend the use of mouthwash containing 1.5% hydrogen peroxide (H 2 O 2 ) or 0.2% povidone iodine (PI) to reduce the viral load in the upper respiratory tract and decrease the risk of transmission. The aim of the present study was to analyze the effect of mouth rinsing and gargling with mouthwash containing 1% PI, 0.5% PI, 3% H 2 O 2 , or 1.5% H 2 O 2 and water on the cycle threshold (CT) value obtained by real-time reverse transcription polymerase chain reaction (RT-PCR). Methods: This study is a randomized single blind controlled clinical trial which has been registered in the International Standard Randomized Controlled Trial Number (ISRCTN) registry on the 3 rd February 2022 (Registration number: ISRCTN18356379). In total, 69 subjects recruited from Persahabatan General Hospital who met the inclusion criteria were randomly assigned to one of four treatment groups or the control group. The subjects were instructed to gargle with 15 mL of mouthwash for 30 s in the oral cavity followed by 30 s in Open Peer Review Approval Status AWAITING PEER REVIEW Any reports and responses or comments on the article can be found at the end of the article.

Data are available under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0). Author contributions • Lilies Dwi Sulistyani conceived and designed the analysis, verified the analytical methods, gaining resources, supervised the study, in charge of overall direction and planning, wrote and revised the paper • Vera Julia conceived and designed the analysis, verified the analytical methods, supervised the study, wrote and revised the paper • Andrianto Soeprapto performed the experiment and analysis, drafted and revised the paper • Rumartha Putri Swari performed the experiment and analysis, drafted the paper • Febriadi Rosmanato performed the experiment and analysis, drafted the paper

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