Potential mouth rinses and nasal sprays that reduce SARS-CoV-2 viral load: What we know so far?

Telles-Araujo, Gabriel de Toledo; Caminha, Raquel D’Aquino Garcia; Kallás, Monira Samaan; Sipahi, Aytan Miranda; Santos, Paulo Sérgio da Silva

doi:10.6061/clinics/2020/e2328

“…The authors highlight that periodontal tissue can be a target for SARS-CoV-2, and contribute to the presence of the virus in saliva. Therefore, the hole of oral hygiene in this circumstance is crucial for preventing the spread of the virus and the use of antiviral oral care products are of paramount importance (27). In this sense, the WHO recommends for dental practices routine asking patients to decontaminate their oral cavity with antiviral mouthwashes prior to examination (13).…”

Section: Discussionmentioning

confidence: 99%

Toothbrushing with a dentifrice containing antimicrobial phthalocyanine derivative for the intraoral reduction of viral load of SARS-CoV-2: a pilot study

Poleti

¹

,

Gregorio

²

,

Bistaffa

³

et al. 2021

Preprint

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Background: The aim of this study was to evaluate the effects of the toothbrushing with a dentifrice containing antimicrobial phthalocyanine derivative (APD) for the intraoral reduction of viral load of SARS-CoV-2.Material and methods: Twenty COVID-19 positive dentate patients were selected and toothbrushes with a dentifrice containing APD for 2 minutes. Self-collected samples of unstimulated saliva were carried out three times: T0 (baseline, before toothbrushing), T5 (5 minutes after toothbrushing), and T30 (30 minutes after toothbrushing). The analysis of RNA viral was performed by RT-PCR using TaqPath™ COVID-19 multiplex Real-Time RT-PCR test for detection of three viral genes (ORF1ab, N and S genes). Evaluation of the effects was based on difference in cycle threshold (Ct) value. Friedman's test and pairwise comparison with Bonferroni corrections were used, with a significance level of 5%. Results: The Ct values were significantly higher (p=0.020) at T30 in comparison to T0 and T5. The greatest difference in the Ct values was between T30 and T0 (3.83). Conclusion: This pilot study suggests that oral hygiene action associated with an antimicrobial chemical dentifrice may be an important tool for SARS-CoV2 viral load reduction in oral cavity.

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“…The virus enters the cell through the connection between the virus spike and the ACE2 receptor, which can be abundantly found in the salivary glands. Therefore, some recommendations have suggested the importance of controlling and reducing the viral load in the oral and oropharynx cavity by using an antiviral mouthwash [8,9,10,11,13,14,33].…”

Section: Discussionmentioning

confidence: 99%

Beneficial effects of a mouthwash containing an antiviral phthalocyanine derivative on the length of hospital stay for COVID-19

Santos

¹

,

Orcina

²

,

Machado

³

et al. 2021

Preprint

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Background: The risk of contamination and dissemination by SARS-CoV-2 has a strong link with nasal, oral and pharyngeal cavities. Recently, our research group observed the promising performance of an anionic phthalocyanine derivative (APD) used in a mouthwash protocol without photoexcitation; this protocol improved the general clinical condition of patients infected with SARS-CoV-2. Methods: The present two-arm study evaluated in vitro the antiviral activity and cytotoxicity of APD. Additionally, a triple-blind randomized controlled trial was conducted with 41 hospitalized patients who tested positive for COVID-19. All the included patients received World Health Organization standard care hospital treatment (non-intensive care) plus active mouthwash (experimental group AM/n=20) or nonactive mouthwash (control group NAM/n=21). The adjunct mouthwash intervention protocol used in both groups consisted one-minute gargling/rinsing / 5 times/day until hospital discharge. Groups were compared considering age, number of comorbidities, duration of symptoms prior admission and length of hospital stay (LOS). The associations between group and sex, age range, presence of comorbidities, admission to Intensive care unit (ICU) and death were also evaluated. Results: The in vitro evaluation demonstrated that APD compound was highly effective for reduction of SARS-CoV-2 viral load in the 1.0 mg/mL (99.96%) to 0.125 mg/mL (92.65%) range without causing cytotoxicity. Regarding the clinical trial, the median LOS of the AM group was significantly shortened (4 days) compared with that of the NAM group (7 days) (p=0.0314). Additionally, gargling/rinsing with APD was very helpful in reducing the severity of symptoms (no ICU care was needed) compared to not gargling/rinsing with APD (28.6% of the patients in the NAM group needed ICU care, and 50% of this ICU subgroup passed way, p=0.0207). Conclusions: This study indicated that the mechanical action of the protocol involving mouthwash containing a compound with antiviral effects against SARS-CoV-2 may reduce the symptoms of the patients and the spread of infection. The use of APD in a mouthwash as an adjuvant the hospital COVID-19 treatment presented no contraindication and reduced the hospital stay period. Trial Registration: The clinical study was registered at REBEC - Brazilian Clinical Trial Register (RBR-58ftdj).

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“…The virus enters the cell through the connection between the virus spike and the ACE2 receptor, which can be abundantly found in the salivary glands. Therefore, some recommendations have suggested the importance of controlling and reducing the viral load in the oral and oropharynx cavity by using an antiviral mouthwash [8,9,10,11,13,14,33].…”

Section: Discussionmentioning

confidence: 99%

Beneficial effects of a mouthwash containing an antiviral phthalocyanine derivative on the length of hospital stay for COVID-19: Randomised trial

Santos

¹

,

Orcina

²

,

Machado

³

et al. 2021

Preprint

View full text Add to dashboard Cite

Background: The risk of contamination and dissemination by SARS-CoV-2 has a strong link with nasal, oral and pharyngeal cavities. Recently, our research group observed the promising performance of an anionic phthalocyanine derivative (APD) used in a mouthwash protocol without photoexcitation; this protocol improved the general clinical condition of patients infected with SARS-CoV-2. Methods: The present two-arm study evaluated in vitro the antiviral activity and cytotoxicity of APD. Additionally, a triple-blind randomized controlled trial was conducted with 41 hospitalized patients who tested positive for COVID-19. All the included patients received World Health Organization standard care hospital treatment (non-intensive care) plus active mouthwash (experimental group AM/n=20) or nonactive mouthwash (control group NAM/n=21). The adjunct mouthwash intervention protocol used in both groups consisted one-minute gargling/rinsing / 5 times/day until hospital discharge. Groups were compared considering age, number of comorbidities, duration of symptoms prior admission and length of hospital stay (LOS). The associations between group and sex, age range, presence of comorbidities, admission to Intensive care unit (ICU) and death were also evaluated. Results: The in vitro evaluation demonstrated that APD compound was highly effective for reduction of SARS-CoV-2 viral load in the 1.0 mg/mL (99.96%) to 0.125 mg/mL (92.65%) range without causing cytotoxicity. Regarding the clinical trial, the median LOS of the AM group was significantly shortened (4 days) compared with that of the NAM group (7 days) (p=0.0314). Additionally, gargling/rinsing with APD was very helpful in reducing the severity of symptoms (no ICU care was needed) compared to not gargling/rinsing with APD (28.6% of the patients in the NAM group needed ICU care, and 50% of this ICU subgroup passed way, p=0.0207). Conclusions: This study indicated that the mechanical action of the protocol involving mouthwash containing a compound with antiviral effects against SARS-CoV-2 may reduce the symptoms of the patients and the spread of infection. The use of APD in a mouthwash as an adjuvant the hospital COVID-19 treatment presented no contraindication and reduced the hospital stay period. Trial Registration: The clinical study was registered at REBEC - Brazilian Clinical Trial Register (RBR-58ftdj) in 10/28/2020.

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Potential mouth rinses and nasal sprays that reduce SARS-CoV-2 viral load: What we know so far?

Cited by 13 publications

References 19 publications

Toothbrushing with a dentifrice containing antimicrobial phthalocyanine derivative for the intraoral reduction of viral load of SARS-CoV-2: a pilot study

Toothbrushing with a dentifrice containing antimicrobial phthalocyanine derivative for the intraoral reduction of viral load of SARS-CoV-2: a pilot study

Beneficial effects of a mouthwash containing an antiviral phthalocyanine derivative on the length of hospital stay for COVID-19

Beneficial effects of a mouthwash containing an antiviral phthalocyanine derivative on the length of hospital stay for COVID-19: Randomised trial

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