Statins-based prophylactic mouthwash and nasal spray may protect against COVID-19

Abdulrab, Saleem; Alkadasi, Baleegh; Al‐Maweri, Sadeq Ali; Halboub, Esam; Alhadainy, Hatem A.; Geerts, Greta

doi:10.1016/j.nmni.2020.100751

Cited by 9 publications

(9 citation statements)

References 13 publications

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“…Statins may help by preventing the development of severe lung injury and acute respiratory distress syndrome (ARDS) by protecting against inflammation via modulation of cytokine over-expression, angiotensin-converting enzyme 2 (ACE2) expression, and the immune response in COVID-19 patients [18,36,37]. Statins have been shown to inhibit nuclear factor kB (NF-kB), which mediates inflam- matory responses during infections [38,39].…”

Section: Discussionmentioning

confidence: 99%

Improved COVID-19 ICU admission and mortality outcomes following treatment with statins: a systematic review and meta-analysis

et al. 2021

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IntroductionApproximately 1% of the world population has now been infected by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19). With cases still rising and vaccines just beginning to rollout, we are still several months away from seeing reductions in daily case numbers, hospitalisations, and mortality. Therefore, there is a still an urgent need to control the disease spread by repurposing existing therapeutics. Owing to antiviral, anti-inflammatory, immunomodulatory, and cardioprotective actions, statin therapy has been considered as a plausible approach to improve COVID-19 outcomes.Material and methodsWe carried out a meta-analysis to investigate the effect of statins on 3 COVID-19 outcomes: intensive care unit (ICU) admission, tracheal intubation, and death. We systematically searched the PubMed, Web of Science, Scopus, and ProQuest databases using keywords related to our aims up to November 2, 2020. All published observational studies and randomised clinical trials on COVID-19 and statins were retrieved. Statistical analysis with random effects modelling was performed using STATA16 software.ResultsThe final selected studies (n = 24 studies; 32,715 patients) showed significant reductions in ICU admission (OR = 0.78, 95% CI: 0.58–1.06; n = 10; I2 = 58.5%) and death (OR = 0.70, 95% CI: 0.55–0.88; n = 21; I2 = 82.5%) outcomes, with no significant effect on tracheal intubation (OR = 0.79; 95% CI: 0.57–1.11; n = 7; I2 = 89.0%). Furthermore, subgroup analysis suggested that death was reduced further by in-hospital application of statins (OR = 0.40, 95% CI: 0.22–0.73, n = 3; I2 = 82.5%), compared with pre-hospital use (OR = 0.77, 95% CI: 0.60–0.98, n = 18; I2 = 81.8%).ConclusionsThese findings call attention to the need for systematic clinical studies to assess both pre- and in-hospital use of statins as a potential means of reducing COVID-19 disease severity, particularly in terms of reduction of ICU admission and total mortality reduction.

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Section: Discussionmentioning

confidence: 99%

Improved COVID-19 ICU admission and mortality outcomes following treatment with statins: a systematic review and meta-analysis

et al. 2021

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“…Beyond the active agents listed in Table 1 , many more candidates are hypothesized but not yet studied, in either in vitro or in vivo experiments, for their actual efficacy in the nasal and oral prophylaxis of SARS-CoV-2. Such are phenolic compounds with proven efficacy against other respiratory viruses (e.g., Quercetin , Hesperidin , Diosmin , Resveratrol ) [ 167 , 305 , 306 , 307 , 308 ], essential oils [ 309 , 310 , 311 , 312 ], quaternary ammonium compounds with broad-spectrum antimicrobial activity [ 313 ] (e.g., Cetylpyridinium chloride , available in the nasal spray product “Halo™”(Oasis Consumer Healthcare, USA) [ 17 ]), statins [ 314 ], and others strictly related to the SARS-CoV-2 entry mechanism therapeutics (e.g., ACE2 agonists [ 315 ] and ACE2-coated nanoparticles [ 316 ]). On the other hand, some very potent antiseptics—viz., Hydrogen peroxide and Chlorhexidine , have not demonstrated the expected efficacy against SARS-CoV-2 [ 317 , 318 , 319 ].…”

Section: The Nasal and Oromucosal Drug Deliverymentioning

confidence: 99%

Advances in the Prophylaxis of Respiratory Infections by the Nasal and the Oromucosal Route: Relevance to the Fight with the SARS-CoV-2 Pandemic

et al. 2022

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In this time of COVID-19 pandemic, the strategies for prevention of the infection are a primary concern. Looking more globally on the subject and acknowledging the high degree of misuse of protective face masks from the population, we focused this review on alternative pharmaceutical developments eligible for self-defense against respiratory infections. In particular, the attention herein is directed to the nasal and oromucosal formulations intended to boost the local immunity, neutralize or mechanically “trap” the pathogens at the site of entry (nose or mouth). The current work presents a critical review of the contemporary methods of immune- and chemoprophylaxis and their suitability and applicability in topical mucosal dosage forms for SARS-CoV-2 prophylaxis.

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“…Popularly used mouthwashes include CHX (60) and povidone-iodine rinse (61). Other agents with potential use are 1.5% hydrogen peroxide (H 2 O 2 ) rinse (62,63), turmeric rinse (64)(65)(66), simvastatin (SMV) mouthwash (67), and essential oil mouthwash (68,69). Further details about these mouthwashes are mentioned subsequently.…”

Section: Oral Rinsesmentioning

confidence: 99%

Oral-Periodontal Health and Cytokine Storm: Correlation and Preventive Measures

Jain

Mallick

2022

Avicenna J Dent Res

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Coronavirus disease 19 (COVID-19) has taken the world by storm, affecting all age groups alike and presenting a plethora of signs and symptoms. Showcasing a high mortality rate, cytokine storm is identified as one of the most common culprits for death in affected individuals. In patients undergoing severe complications in the form of intubations and intensive care unit (ICU) admissions, increased cytokine levels have again been identified as a significant factor, indicating their substantial role in disease outcomes. Periodontitis, which is identified as a silent pandemic, is the most common oral disease that is found in individuals. The increased accumulations of plaques and calculus are the main causative agents, stimulating inflammatory cells in the periodontal tissue, leading to cytokine release. Individuals with the removable or fixed dental prosthesis are at increased risk of contracting fungal infections, which are also identified as increasing the cytokine levels and worsening an individual’s condition contracted with COVID-19. This review focuses on oral hygiene measures and scientifically proven aids that can be used by patients at home for reducing oral cytokine levels and the risk of COVID-19 related complications, thereby sensitizing them at a time when elective dental procedures are discouraged and patients are devoid of professional dental intervention. Mechanical removal of plaques and calculus cannot be substituted with auxiliary aids, but it is important that adjunct practices be adopted for efficient hygiene. Toothbrush hygiene should also be practiced to prevent disease progression and transmission. Adherence to these recommendations is not only required for healthy or infected individuals but also for viral infection recovered patients to avoid the possible risk of developing the black fungus infection.

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Statins-based prophylactic mouthwash and nasal spray may protect against COVID-19

Cited by 9 publications

References 13 publications

Improved COVID-19 ICU admission and mortality outcomes following treatment with statins: a systematic review and meta-analysis

Improved COVID-19 ICU admission and mortality outcomes following treatment with statins: a systematic review and meta-analysis

Advances in the Prophylaxis of Respiratory Infections by the Nasal and the Oromucosal Route: Relevance to the Fight with the SARS-CoV-2 Pandemic

Oral-Periodontal Health and Cytokine Storm: Correlation and Preventive Measures

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