Mateos-Moreno M V, Mira A, Ausina-Márquez V, Ferrer M D
Department of Dental Clinical Specialties, School of Dentistry, Universidad Complutense de Madrid, Madrid, Spain.
Genomics & Health Department, Foundation for the Promotion of Health and Biomedical Research in the Valencian Community (FISABIO), Valencia, Spain; CIBER Center for Epidemiology and Public Health, Madrid, Spain.
J Hosp Infect. 2021 Jul;113:30-43. doi: 10.1016/j.jhin.2021.04.004. Epub 2021 Apr 15.
Angiotensin converting enzyme 2 (ACE2) is the cellular receptor for SARS-CoV-2, so ACE2-expressing cells can act as target cells and are susceptible to infection. ACE2 receptors are highly expressed in the oral cavity, so this may be a potential high-risk route for SARS-CoV-2 infection. Furthermore, the virus can be detected in saliva, even before COVID-19 symptoms appear, with the consequent high risk of virus transmission in asymptomatic/presymptomatic patients. Reducing oral viral load could lead to a lower risk of transmission via salivary droplets or aerosols and therefore contribute to the control of the pandemic. Our aim was to evaluate the available evidence testing the in-vitro and in-vivo effects of oral antiseptics to inactivate or eradicate coronaviruses. The criteria used were those described in the PRISMA declaration for performing systematic reviews. An electronic search was conducted in Medline (via PubMed) and in Web of Sciences, using the MeSH terms: 'mouthwash' OR 'oral rinse' OR 'mouth rinse' OR 'povidone iodine' OR 'hydrogen peroxide' OR 'cetylpyridinium chloride' AND 'COVID-19' OR 'SARS-CoV-2' OR 'coronavirus' OR 'SARS' OR 'MERS'. The initial search strategy identified 619 articles on two electronic databases. Seventeen articles were included assessing the virucidal efficacy of oral antiseptics against coronaviruses. In conclusion, there is sufficient in-vitro evidence to support the use of antiseptics to potentially reduce the viral load of SARS-CoV-2 and other coronaviruses. However, in-vivo evidence for most oral antiseptics is limited. Randomized clinical trials with a control group are needed to demonstrate its clinical efficacy.
血管紧张素转换酶2(ACE2)是严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的细胞受体,因此表达ACE2的细胞可作为靶细胞,易受感染。ACE2受体在口腔中高度表达,所以这可能是SARS-CoV-2感染的一个潜在高风险途径。此外,甚至在COVID-19症状出现之前就能在唾液中检测到病毒,无症状/症状前患者存在很高的病毒传播风险。降低口腔病毒载量可能会降低通过唾液飞沫或气溶胶传播的风险,从而有助于控制疫情。我们的目的是评估现有证据,检验口腔消毒剂灭活或根除冠状病毒的体外和体内效果。使用的标准是PRISMA声明中描述的进行系统评价的标准。通过在Medline(通过PubMed)和Web of Sciences中进行电子检索,使用医学主题词:“漱口水”或“口腔冲洗液”或“口洗液”或“聚维酮碘”或“过氧化氢”或“西吡氯铵”以及“COVID-19”或“SARS-CoV-2”或“冠状病毒”或“SARS”或“中东呼吸综合征”。初步检索策略在两个电子数据库中识别出619篇文章。纳入了17篇评估口腔消毒剂对冠状病毒杀病毒效力的文章。总之,有足够的体外证据支持使用消毒剂来潜在降低SARS-CoV-2和其他冠状病毒的病毒载量。然而,大多数口腔消毒剂的体内证据有限。需要有对照组的随机临床试验来证明其临床疗效。