Summary of COVID-19 hydrogen peroxide studies

1. Agrawal et al., Prospective Randomized Double-blind Placebo-controlled Study to Assess the Effects of Nano-ozonized Hydrogen Peroxide Nebulization on Results of RTPCR for Novel Coronavirus thus Infectivity and Clinical Course among Moderately Sick COVID-19 Patients

40 patient hydrogen peroxide late treatment RCT: 46% lower need for oxygen therapy (p<0.0001), 36% faster recovery (p<0.0001), and 45% faster viral clearance (p<0.0001).
RCT 40 patients in India, showing improved recovery with nebulized hydrogen peroxide.
Apr 2022, J. South Asian Federation of Obstetrics and Gynaecology, https://www.jsafog.com/doi/10.5005/jp-journals-10006-1986, https://c19p.org/agrawal

2. Di Domênico et al., Effectiveness of hydrogen peroxide as auxiliary treatment for hospitalized COVID-19 patients in Brazil: preliminary results of a randomized double-blind clinical trial

40 patient hydrogen peroxide late treatment RCT: 50% lower ICU admission (p=1), 6% greater improvement (p=0.91), and 7% higher hospital discharge (p=0.61).
RCT very late treatment (>10 days from onset) comparing hydrogen peroxide + mint essence with water + mint essence, showing no significant differences.
Apr 2021, Epidemiology and Health, http://e-epih.org/journal/view.php?doi=10.4178/epih.e2021032, https://c19p.org/didomenico

3. Mukhtar et al., A Randomized trial on the regular use of potent mouthwash in COVID-19 treatment

92 patient hydrogen peroxide early treatment RCT: 86% lower mortality (p=0.24), 86% lower ventilation (p=0.24), and 18% improved viral clearance (p=0.16).
RCT for mouthwash containing hydrogen peroxide 2% and chlorhexidine gluconate, showing higher discharge, shorter hospital stay, less intubation, and lower mortality with treatment.
Nov 2020, medRxiv, https://www.medrxiv.org/content/10.1101/2020.11.27.20234997v2, https://c19p.org/mukhtar

4. Di Domênico et al., Hydrogen peroxide as an auxiliary treatment for COVID-19 in Brazil: a randomized double-blind clinical trial

128 patient hydrogen peroxide late treatment RCT: 34% lower ICU admission (p=1), 1% worse recovery (p=0.97), and 31% lower PASC (p=0.54).
RCT very late treatment (>9 days from onset) comparing hydrogen peroxide + mint essence with water + mint essence, showing no significant differences.
Aug 2021, Epidemiology and Health, http://e-epih.org/journal/view.php?doi=10.4178/epih.e2021051, https://c19p.org/didomenico2

5. Amoah et al., Further observations on hydrogen peroxide antisepsis and COVID-19 cases among healthcare workers and inpatients

466 patient hydrogen peroxide prophylaxis study: 93% fewer cases (p=0.06).
Retrospective 458 healthcare workers in Ghana, showing lower COVID-19 cases with hydrogen peroxide prophylaxis (oral and nasal rinse), without statistical significance.
Aug 2022, J. Hospital Infection, https://www.sciencedirect.com/science/article/pii/S0195670122001499, https://c19p.org/amoah

6. Jayaraman et al., Povidone iodine, hydrogen peroxide and chlorhexidine mouthwashes reduce SARS-CoV2 burden in whole mouth fluid and respiratory droplets

12 patient hydrogen peroxide early treatment study: 50% improved viral clearance (p=0.18).
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 significant reductions in SARS-CoV-2 burden with all treatments in both respiratory droplets and whole mouth fluid. . Authors perform antigen testing for 6 hydrogen peroxide patients, showing that 50% became negative after treatment.
Feb 2021, medRxiv, https://www.medrxiv.org/content/10.1101/2021.02.25.21252488v1, https://c19p.org/jayaramanhp

7. Pablo-Marcos et al., Utility of mouth rinses with povidone-iodine and hydrogen peroxide in patients with COVID-19

71 patient hydrogen peroxide early treatment study: 12% improved viral clearance (p=0.67).
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, and only every 8 hours for two days. Results may be better with the addition of nasopharyngeal use, more frequent use, and without the two day limit. Authors report only one of the 7 previous trials for PVP-I and COVID-19. Non-randomized study with no adjustments or group details. Some results in Figure 1 appear to be switched compared to the text and the labels in the figure. The viral clearance figures do not match the group sizes - for example authors report 62% PCR- for PVP-I at the 3rd test, however there is no number of 31 patients that rounds to 62%.
Oct 2021, Enfermedades Infecciosas y Microbiología Clínica, https://www.sciencedirect.com/science/article/pii/S0213005X21002950, https://c19p.org/pablomarcoshp

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