Castro-Ruiz Carmen, Vergara-Buenaventura Andrea
Department of Periodontology, School of Dentistry, Universidad Científica del Sur, Lima, Peru.
J Int Soc Prev Community Dent. 2020 Oct 19;10(6):681-685. doi: 10.4103/jispcd.JISPCD_304_20. eCollection 2020 Nov-Dec.
Patients are mask-free during dental attention. In addition, dentists and dental staff after working for hours need to hydrate or eat. Removing the mask makes them vulnerable to the risk of contamination. For those cases, a prophylactic decontamination protocol could be useful as an adjunct to the most recommended biosecurity protocols. This article aims to provide a comprehensive review of the published evidence about the use of povidone-iodine (PVP-I) against SARS-CoV-2 and to propose a prophylactic protocol for dental attention using PVP-I during the COVID-19 pandemic.
An electronic search in Medline via PubMed, Scopus, Cochrane Library and Scielo databases was performed up to July 24, 2020, to identify relevant literature focusing on Povidone Iodine, SARS-CoV-2, COVID-19, SARS-COV, MERS, antiviral mouthwashes, and oral cavity.
Clinical studies on the virucidal effectiveness of PVP-I against SARS-CoV-2 have not yet been reported. We identify a recent study showing PVP-I effectiveness at 0.5, 1, and 1.5% within 15s of contact. Moreover, another study has shown ≥99.99% virucidal activity as 1% mouthwash and 0.45% throat spray. The only study in SARS-CoV-2 confirmed patients reported a significant 3h drop in viral load after rinsing with 15 mL of 1% PVP-I for 1min.
Although no clinical trials have reported the efficacy of PVP-I on SARS-CoV-2, recent studies in patients with positive PCR to SARS-CoV-2 found a significant 3-h drop in viral load. We believe that an oral prophylactic protocol with PVP-I for dental healthcare workers and patients as an adjunct to the current biosecurity protocol could minimize the transmission risk during COVID-19 pandemic.
患者在接受牙科治疗时不戴口罩。此外，牙医和牙科工作人员工作数小时后需要补充水分或进食。摘下口罩会使他们面临污染风险。对于这些情况，预防性消毒方案作为最推荐的生物安全方案的辅助手段可能会很有用。本文旨在全面综述已发表的关于聚维酮碘（PVP-I）对抗严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的证据，并提出在2019冠状病毒病（COVID-19）大流行期间使用PVP-I进行牙科治疗的预防性方案。
截至2020年7月24日，通过PubMed、Scopus、Cochrane图书馆和Scielo数据库在Medline中进行电子检索，以识别聚焦于聚维酮碘、SARS-CoV-2、COVID-19、严重急性呼吸综合征冠状病毒（SARS-COV）、中东呼吸综合征（MERS）、抗病毒漱口水和口腔的相关文献。
尚未有关于PVP-I对SARS-CoV-2的杀病毒效果的临床研究报告。我们发现一项近期研究表明，接触15秒内，0.5%、1%和1.5%的PVP-I具有有效性。此外，另一项研究表明，1%的漱口水和0.45%的咽喉喷雾剂具有≥99.99%的杀病毒活性。唯一一项针对SARS-CoV-2确诊患者的研究报告称，用15毫升1%的PVP-I漱口1分钟后，病毒载量在3小时内显著下降。
尽管尚无临床试验报告PVP-I对SARS-CoV-2的疗效，但近期对SARS-CoV-2核酸检测呈阳性患者的研究发现，病毒载量在3小时内显著下降。我们认为，作为当前生物安全方案的辅助手段，为牙科医护人员和患者制定的含PVP-I的口腔预防性方案可在COVID-19大流行期间将传播风险降至最低。
