Conv. Plasma
Nigella Sativa

All povidone‑iodine studies
Meta analysis
study COVID-19 treatment researchPVP-IPovidone-Iod.. (more..)
Melatonin Meta
Azvudine Meta Metformin Meta
Bromhexine Meta
Budesonide Meta Molnupiravir Meta
Colchicine Meta
Conv. Plasma Meta
Curcumin Meta Nigella Sativa Meta
Famotidine Meta Nitazoxanide Meta
Favipiravir Meta Paxlovid Meta
Fluvoxamine Meta Quercetin Meta
Hydroxychlor.. Meta Remdesivir Meta
Ivermectin Meta
Lactoferrin Meta

All Studies   Meta Analysis   Recent:  

Efficacy of mouthwash on reducing salivary SARS-CoV-2 viral load and clinical symptoms: a systematic review and meta-analysis

Zhang et al., BMC Infectious Diseases, doi:10.1186/s12879-023-08669-z, PROSPERO CRD42023401961
Oct 2023  
  Source   PDF   All Studies   Meta AnalysisMeta
Systematic review and meta-analysis of 13 randomized controlled trials with a total of 832 participants analyzing the efficacy of mouthwash on reducing salivary SARS-CoV-2 viral load and clinical symptoms in COVID-19 patients. Authors found that mouthwash had a significant positive effect on the CT values of SARS-CoV-2 compared to control, indicating lower viral loads. Subgroup analyses showed mouthwashes containing chlorhexidine, povidone-iodine, and hydrogen peroxide were associated with higher CT values. However, there was no significant difference in direct viral load measurements between mouthwash and control groups overall. Authors conclude that mouthwash, especially containing povidone-iodine, may help reduce SARS-CoV-2 viral load, but more research is needed on dosing and frequency of use.
This study includes povidone-iodine, cetylpyridinium chloride, chlorhexidine, and hydrogen peroxide.
Zhang et al., 11 Oct 2023, peer-reviewed, 6 authors, trial PROSPERO CRD42023401961.
All Studies   Meta Analysis   Submit Updates or Corrections
This PaperPovidone-Iod..All
Efficacy of mouthwash on reducing salivary SARS-CoV-2 viral load and clinical symptoms: a systematic review and meta-analysis
Mingrui Zhang, Nan Meng, Hong Duo, Yuanbo Yang, Qing Dong, Jianqi Gu
BMC Infectious Diseases, doi:10.1186/s12879-023-08669-z
Background COVID-19 has been a public health emergency of international concern (PHEIC) for a lengthy period of time. The novel coronavirus is primarily spread via aerosols at a short distance, with infected individuals releasing large amounts of aerosols when speaking and coughing. However, there is an open question regarding whether mouthwash could effectively reduce virus transmission during the COVID-19 pandemic and support the prevention of infection among medical workers. Methods Cochrane Library, PubMed, Web of Science, and Embase databases were systematically searched from the inception of each database to January 12, 2023 for currently available randomized clinical trials (RCTs) on the effect of mouthwash on novel coronavirus load in the oral cavity in COVID-19 patients. The treatment group received mouthwash for rinsing the mouth, while the control group received a placebo or distilled water for COVID-19 patients. The primary outcomes were CT value and viral load. Odds ratios (ORs) were estimated using a random-effects model. Subgroup and sensitivity analyses were performed to minimize the bias and the impact of heterogeneity. Results Thirteen RCTs were included. Seven studies reported the intervention effect of mouthwash on the CT value of novel coronavirus. The analysis results showed that the mouthwash group had a positive impact on the CT value of novel coronavirus [ SMD = 0.35, 95% CI (0.21, 0.50)] compared with the control group. In addition, subgroup analysis showed a significant positive effect of mouthwash on CT values in the treatment group compared with the control group, with chlorhexidine (CHX) [SMD = 0.33, 95% CI (0.10, 0.56)], povidone-iodine (PVP-I) [SMD = 0.61, 95% CI (0.23, 0.99)], or hydrogen peroxide (HP) [SMD = 1.04, 95% CI (0.30, 1.78)] as an ingredient of the mouthwash. Six studies reported the intervention effect of mouthwash on the viral load, 263 cases in the treatment group and 164 cases in the control group. The analysis results showed that there was no statistical difference between the mouthwash group and the control group in the viral load of novel coronavirus [SMD = -0.06, 95% CI (-0.18, 0.05)]. In the subgroup analysis by measurement time, there were statistically significant differences between the mouthwash and control groups for CT values [SMD = 0.52, 95% CI (0.31, 0.72)] and viral load [SMD = -0.32, 95% CI (-0.56, -0.07)] within 30 min of gargling.
Supplementary Information The online version contains supplementary material available at https:// doi. org/ 10. 1186/ s12879-023-08669-z. Additional file 6: Table S1 . Search strategy. Authors' contributions Conceptualization: Qing Dong, Jianqi Gu; Methodology: Nan Meng, Mingrui Zhang, Hong Duo; Formal analysis and investigation: Nan Meng, Mingrui Zhang, Hong Duo, Yuanbo Yang; Writing-original draft preparation: Mingrui Zhang, Nan Meng; Writing-review and editing: Qing Dong, Jianqi Gu; Funding acquisition: Qing Dong, Yuanbo Yang; Resources: Qing Dong, Yuanbo Yang; Supervision: Qing Dong, Jianqi Gu. And all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript. Declarations Ethics approval and consent to participate All analyses were based on previous published studies, thus no ethical approval and patient consent are required. Consent for publication Not applicable. Competing interests The authors declare no competing interests. • fast, convenient online submission • thorough peer review by experienced researchers in your field • rapid publication on acceptance • support for research data, including large and complex data types • gold Open Access which fosters wider collaboration and increased citations maximum visibility for your research: over 100M website views per year • At BMC, research is always in progress. Learn more Ready to submit your research Ready to submit your..
Alemany, Perez-Zsolt, Raïch-Regué, Muñoz-Basagoiti, Ouchi et al., Cetylpyridinium chloride mouthwash to reduce shedding of infectious SARS-CoV-2: a double-blind randomized clinical trial, J Dent Res
Alzahrani, Bamashmous, Alkharobi, Alghamdi, Alharbi et al., Mouth rinses efficacy on salivary SARS-CoV-2 viral load: a randomized clinical trial, J Med Virol
Arteagoitia, Andrés, Ramos, Does chlorhexidine reduce bacteremia following tooth extraction? A systematic review and metaanalysis, PLoS ONE
Ather, Patel, Ruparel, Diogenes, Hargreaves, Coronavirus Disease 19 (COVID-19): Implications for clinical dental care, J Endodontics
Barrueco, Moreno, Martínez-Beneyto, García-Vázquez, González et al., Effect of oral antiseptics in reducing SARS-CoV-2 infectivity: evidence from a randomized double-blind clinical trial, Emerg Microbes Infect
Bidra, Pelletier, Westover, Frank, Brown et al., Comparison of In Vitro Inactivation of SARS CoV-2 with Hydrogen Peroxide and Povidone-Iodine Oral Antiseptic Rinses, J Prosthodontics
Carrouel, Gonçalves, Conte, Campus, Fisher et al., Antiviral activity of reagents in mouth rinses against SARS-CoV-2, J Dent Res
Carrouel, Valette, Gadea, Esparcieux, Illes et al., Use of an antiviral mouthwash as a barrier measure in the SARS-CoV-2 transmission in adults with asymptomatic to mild COVID-19: a multicentre, randomized, double-blind controlled trial, Clin Microbiol Infect
Cavalcante-Leão, De Araujo, Basso, Schroder, Guariza-Filho et al., Is there scientific evidence of the mouthwashes effectiveness in reducing viral load in Covid-19? A systematic review, J Clin Exp Dent
Chen, Chang, The effectiveness of mouthwash against SARS-CoV-2 infection: A review of scientific and clinical evidence, J Formosan Med Assoc =Taiwan Yi Zhi
Costa, Brites, Vaz, De Santana, Santos et al., Chlorhexidine mouthwash reduces the salivary viral load of SARS-CoV-2: a randomized clinical trial, Oral Dis
Da Fonseca Orcina, Vilhena, De, Oliveira, Da et al., A Phthalocyanine derivate mouthwash to gargling/rinsing as an option to reduce clinical symptoms of COVID-19: case series, Clin Cosmetic Invest Dentistry
Da, Santos, Da Fonseca, Machado, Vilhena et al., Beneficial effects of a mouthwash containing an antiviral phthalocyanine derivative on the length of hospital stay for COVID-19: randomised trial, Sci Rep
Davis, Mccorkell, Vogel, Topol, Long COVID: major findings, mechanisms and recommendations, Nat Rev Microbiol
Eduardo, Corrêa, Heller, Daep, Benitez et al., Salivary SARS-CoV-2 load reduction with mouthwash use: a randomized pilot clinical trial, Heliyon
Elzein, Sater, Fakhreddine, Hanna, Feghali et al., In vivo evaluation of the virucidal efficacy of chlorhexidine and povidone-iodine mouthwashes against salivary SARS-CoV-2. A randomized-controlled clinical trial, J Evid-Based Dental Pract
Fernandez, Guedes, Langa, Rösing, Cavagni et al., Virucidal efficacy of chlorhexidine: a systematic review, Odontology
Ferrer, Barrueco, Martinez-Beneyto, Moreno, Ausina-Márquez et al., Clinical evaluation of antiseptic mouth rinses to reduce salivary load of SARS-CoV-2, Sci Rep
Garcia-Sanchez, Peña-Cardelles, Salgado-Peralvo, Robles, Ordonez-Fernandez et al., Virucidal activity of different mouthwashes against the salivary load of SARS-CoV-2: a narrative review, Healthc
Gray, Katelaris, Lipson, Recurrent anaphylaxis caused by topical povidone-iodine (Betadine), J Paediatr Child Health
Gül, Dilsiz, Sağlık, Aydın, Effect of oral antiseptics on the viral load of SARS-CoV-2: a randomized controlled trial, Dental Med Prob
Hernández-Vásquez, Barrenechea-Pulache, Comandé, Azañedo, Mouthrinses and SARS-CoV-2 viral load in saliva: a living systematic review, Evid Based Dent, doi:10.1038/s41432-022-0253-z
Huang, Huang, Use of chlorhexidine to eradicate oropharyngeal SARS-CoV-2 in COVID-19 patients, J Med Virol
Huang, Pérez, Kato, Mikami, Okuda et al., SARS-CoV-2 infection of the oral cavity and saliva, Nat Med
Idrees, Mcgowan, Fawzy, Abuderman, Balasubramaniam et al., Efficacy of Mouth Rinses and Nasal Spray in the Inactivation of SARS-CoV-2: A Systematic Review and Meta-Analysis of In Vitro and In Vivo Studies, Int J Environ Res Public Health
Joynt, Wu, Understanding COVID-19: what does viral RNA load really mean?, Lancet Infect Dis
Kohn, Collins, Cleveland, Harte, Eklund et al., Guidelines for infection control in dental health-care settings-2003, MMWR Recommend Rep
Kumar, Mishra, Dunn, Townsend, Oguadinma et al., Biocides and novel antimicrobial agents for the mitigation of coronaviruses, Front Microbiol
Liberati, Altman, Tetzlaff, Mulrow, Gøtzsche et al., The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration, BMJ (Clin Res Ed)
Mcvernon, Liberman, WHO keeps covid-19 a public health emergency of international concern, BMJ (Clinical Research Ed)
Meister, Gottsauner, Schmidt, Heinen, Todt et al., Mouthrinses against SARS-CoV-2 -High antiviral effectivity by membrane disruption in vitro translates to mild effects in a randomized placebo-controlled clinical trial, Virus Res
Natto, Bakhrebah, Afeef, Al-Harbi, Nassar et al., The short-term effect of different chlorhexidine forms versus povidone iodine mouth rinse in minimizing the oral SARS-CoV-2 viral load: An open label randomized controlled clinical trial study, Medicine
Pattanshetty, Narayana, Radhakrishnan, Povidone-iodine gargle as a prophylactic intervention to interrupt the transmission of SARS-CoV-2, Oral Dis
Peng, Xu, Li, Cheng, Zhou et al., Transmission routes of 2019-nCoV and controls in dental practice, Int J Oral Sci
Poleti, Gregório, Bistaffa, Fernandes, Vilhena et al., use of mouthwash and dentifrice containing an antimicrobial phthalocyanine derivative for the reduction of clinical symptoms of covid-19: a randomized triple-blind clinical trial, J Evid Based Dent Pract
Sachs, Karim, Aknin, Allen, Brosbøl et al., The Lancet Commission on lessons for the future from the COVID-19 pandemic, Lancet
Seneviratne, Balan, Ko, Udawatte, Lai et al., Efficacy of commercial mouth-rinses on SARS-CoV-2 viral load in saliva: randomized control trial in Singapore, Infection
Tang, Schmitz, Persing, Stratton, Laboratory diagnosis of COVID-19: current issues and challenges, J Clin Microbiol
Tarragó-Gil, Mj, Salcedo, Alvarez, Ainaga et al., Randomized clinical trial to assess the impact of oral intervention with cetylpyridinium chloride to reduce salivary SARS-CoV-2 viral load, J Clin Periodontol
Wu, Leung, Leung, Nowcasting and forecasting the potential domestic and international spread of the 2019-nCoV outbreak originating in Wuhan, China: a modelling study, Lancet
Wölfel, Corman, Guggemos, Seilmaier, Zange et al., Virological assessment of hospitalized patients with COVID-2019, Nature
Xu, Zhong, Deng, Peng, Dan et al., High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa, Int J Oral Sci
Zemouri, Volgenant, Buijs, Crielaard, Rosema et al., Dental aerosols: microbial composition and spatial distribution, J Oral Microbiol
Please send us corrections, updates, or comments. c19early involves the extraction of over 100,000 datapoints from thousands of papers. Community updates help ensure high accuracy. Vaccines and treatments are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment, vaccine, or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
  or use drag and drop