Zarabanda: The Effect of Povidone-Iodine Nasal Spray on COVID-19 Nasopharyngeal Viral Load in Patients: A Randomized Control Trial

The Effect of Povidone-Iodine Nasal Spray on COVID-19 Nasopharyngeal Viral Load in Patients: A Randomized Control Trial

Zarabanda et al., Laryngoscope, doi:10.1002/lary.29935

Zarabanda et al., The Effect of Povidone-Iodine Nasal Spray on COVID-19 Nasopharyngeal Viral Load in Patients: A Randomized.., Laryngoscope, doi:10.1002/lary.29935

Nov 2021 Source PDF

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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 in other trials). There are large unadjusted differences between groups, e.g. 7.1 days from onset for PVP-I versus 4.8 for saline. Baseline Ct was higher for PVP-I, providing less room for improvement. Authors note that they cannot determine if earlier use is more beneficial.

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risk of no recovery, 26.9% higher, RR 1.27, p = 1.00, treatment 3 of 13 (23.1%), control 2 of 11 (18.2%), 2%.

risk of no recovery, 50.0% higher, RR 1.50, p = 1.00, treatment 3 of 11 (27.3%), control 2 of 11 (18.2%), 0.5%.

risk of no viral clearance, no change, RR 1.00, p = 1.00, treatment 2 of 7 (28.6%), control 2 of 7 (28.6%), day 5, minus strand PCR.

Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates

Zarabanda et al., 1 Nov 2021, Randomized Controlled Trial, USA, peer-reviewed, 13 authors, average treatment delay 7.0 days, this trial compares with another treatment - results may be better when compared to placebo.

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This Paper Povidone-Iod..All

The Effect of Povidone‐Iodine Nasal Spray on Nasopharyngeal SARS‐CoV‐2 Viral Load: A Randomized Control Trial

MD David Zarabanda, MD Neelaysh Vukkadala, MD Katie M Phillips, Z Jason Qian, Kenji O Mfuh, Matthew J Hatter, MD Ivan T Lee, MD Vidya K Rao, MD Peter H Hwang, MD George Domb, Orcid ID Zara M Patel, MD PhD Benjamin A Pinsky, MD PhD Jayakar V Nayak

The Laryngoscope, doi:10.1002/lary.29935

Objectives To determine the effect of povidone-iodine (PVP-I) nasal sprays on nasopharyngeal (NP) viral load as assessed by cycle threshold on quantitative polymerase chain reaction (qPCR) of SARS-CoV-2 in outpatients. Study Design Three arm, triple blinded, randomized, placebo-controlled clinical trial. Methods Participants were randomized within 5 days of testing positive for COVID-19 to receive nasal sprays containing either placebo (0.9% saline), 0.5% PVP-I, or 2.0% PVP-I. NP swabs for qPCR analysis were taken at baseline, 1-hour post-PVP-I spray (2 sprays/nostril),

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Late treatment
is less effective

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