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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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Improvement in Ct value 6% Improvement Relative Risk Improvement in Ct value (b) 11% Povidone-Iodine  Sulistyani et al.  EARLY TREATMENT  RCT Is early treatment with povidone-iodine beneficial for COVID-19? RCT 30 patients in Indonesia (July - September 2021) No significant difference in viral clearance c19early.org Sulistyani et al., F1000Research, March 2022 Favorspovidone-iodine Favorscontrol 0 0.5 1 1.5 2+
PVP-I for COVID-19
12th treatment shown to reduce risk in February 2021
 
*, now with p = 0.000000004 from 21 studies.
Lower risk for mortality, cases, and viral clearance.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,300+ studies for 75 treatments. c19early.org
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.
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.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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 PaperPovidone-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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The American Dental Association and the Centers for Disease Control and ' 'Prevention recommend the use of mouthwash containing 1.5% hydrogen peroxide ' '(H<ns4:sub>2</ns4:sub>O<ns4:sub>2</ns4:sub>) 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<ns4:sub>2</ns4:sub>O<ns4:sub>2</ns4:sub>, or 1.5% ' 'H<ns4:sub>2</ns4:sub>O<ns4:sub>2</ns4:sub> and water on the cycle threshold (CT) value ' 'obtained by real-time reverse transcription polymerase chain reaction ' '(RT-PCR).</ns4:p><ns4:p> <ns4:bold>Methods:</ns4:bold> 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<ns4:sup>rd</ns4:sup> 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 the back of the throat, three times ' 'per day for 5 days. CT values were collected on postprocedural days 1, 3, and ' '5.</ns4:p><ns4:p> <ns4:bold>Results:</ns4:bold> The results of the Friedman test ' 'significantly differed among the groups (n=15). The CT values increased from baseline (day 0) ' 'to postprocedural days 1, 3, and 5.</ns4:p><ns4:p> <ns4:bold>Conclusions:</ns4:bold> Mouth ' 'rinsing and gargling with mouthwash containing 1% PI, 0.5% PI, 3% ' 'H<ns4:sub>2</ns4:sub>O<ns4:sub>2</ns4:sub>, or 1.5% ' 'H<ns4:sub>2</ns4:sub>O<ns4:sub>2</ns4:sub> and water increased the CT value.</ns4:p>', 'DOI': '10.12688/f1000research.110843.1', 'type': 'journal-article', 'created': {'date-parts': [[2022, 11, 1]], 'date-time': '2022-11-01T11:50:09Z', 'timestamp': 1667303409000}, 'page': '1238', 'update-policy': 'http://dx.doi.org/10.12688/f1000research.crossmark-policy', 'source': 'Crossref', 'is-referenced-by-count': 0, 'title': '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', 'prefix': '10.12688', 'volume': '11', 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