Graves C, Ghaltakhchyan N, Ngo T Q, Liu C, Babikow E, Shoji A, Bocklage C, Sang Y, Phillips S T, Bowman N, Frazier-Bowers S, Freire M, Wallet S, Divaris K, Wu D, Jacox L A
Department of Biomedical Sciences, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA.
Department of Orthodontics, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA.
JDR Clin Trans Res. 2024 Dec 9;10(4):23800844241296840. doi: 10.1177/23800844241296840.
Evaluating the antiviral potential of commercially available mouthrinses on SARS-CoV-2 holds potential for reducing transmission, particularly as novel variants emerge. Because SARS-CoV-2 is transmitted primarily through salivary and respiratory secretions and aerosols, strategies to reduce salivary viral burden in an antigen-agnostic manner are attractive for mitigating spread in dental, otolaryngology, and orofacial surgery clinics where patients may need to unmask.
Patients ( = 128) with confirmed COVID-19-positive status within 10 days of symptom onset or positive test result were enrolled in a double-blind randomized controlled trial of Food and Drug Administration-approved mouthrinses containing active ingredients ethanol, hydrogen peroxide, povidone iodine, chlorhexidine gluconate, cetylpyridinium chloride (CPC), or saline. The CPC, ethanol, and sterile water rinses were followed in a second double-blind randomized controlled trial ( = 230). Participants provided a saliva sample before rinsing (baseline) and again at 30 and 60 min after rinse. Quantitative polymerase chain reaction was used to determine salivary SARS-CoV-2 viral load at all time points. An adjusted linear mixed-effect model was employed to compare viral load after rinsing relative to baseline.
The rinse containing CPC significantly reduced salivary SARS-CoV-2 viral load 30 min postrinse relative to baseline ( = .015), whereas no other rinse significantly affected viral load at 30 min after rinsing. At 60 min postrinsing, no group had a significant reduction in SARS-CoV-2 copy number relative to baseline, indicating a rebound in salivary viral load over a 1-hour window. Participants indicated a fair to good rinsing experience with the CPC product and high willingness to use oral rinses before and during dental and medical health care visits.
Our findings suggest that preprocedural oral rinsing could be implemented as a feasible, inexpensive approach to mitigate spread of SARS-CoV-2 and potentially other enveloped viruses for short periods, which is relevant to clinical procedures involving the nasal and oropharyngeal region.
Rinsing with a cetylpyridinium chloride-containing mouthrinse can significantly reduce salivary SARS-CoV-2 viral load for up to 30 min; patients are willing to use mouthrinses in medical and dental settings to limit transmission risk in clinics.
评估市售漱口水对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的抗病毒潜力，对于减少病毒传播具有重要意义，尤其是在新变种出现的情况下。由于SARS-CoV-2主要通过唾液、呼吸道分泌物和气溶胶传播，因此以抗原非特异性方式降低唾液病毒载量的策略，对于减轻牙科、耳鼻喉科和口腔颌面外科诊所中的传播具有吸引力，因为这些诊所中的患者可能需要摘下口罩。
在症状出现或检测结果呈阳性的10天内确诊为COVID-19阳性的患者（n = 128），被纳入一项双盲随机对照试验，该试验使用了美国食品药品监督管理局批准的含有活性成分乙醇、过氧化氢、聚维酮碘、葡萄糖酸氯己定、西吡氯铵（CPC）或生理盐水的漱口水。在第二项双盲随机对照试验（n = 230）中，使用了CPC、乙醇和无菌水漱口水。参与者在漱口前（基线）以及漱口后30分钟和60分钟再次提供唾液样本。使用定量聚合酶链反应来测定所有时间点的唾液SARS-CoV-2病毒载量。采用调整后的线性混合效应模型来比较漱口后相对于基线的病毒载量。
含有CPC的漱口水在漱口后30分钟相对于基线显著降低了唾液SARS-CoV-2病毒载量（P = 0.015），而其他漱口水在漱口后30分钟均未对病毒载量产生显著影响。在漱口后60分钟，相对于基线，没有一组的SARS-CoV-2拷贝数有显著降低，这表明在1小时的时间段内唾液病毒载量出现了反弹。参与者表示使用CPC产品的漱口体验良好，并且在牙科和医疗保健就诊前及就诊期间使用漱口水的意愿很高。
我们的研究结果表明，术前口腔漱口可作为一种可行、廉价的方法，在短时间内减轻SARS-CoV-2以及可能其他包膜病毒的传播，这与涉及鼻腔和口咽区域的临床操作相关。
用含西吡氯铵的漱口水漱口可显著降低唾液SARS-CoV-2病毒载量长达30分钟；患者愿意在医疗和牙科环境中使用漱口水以限制诊所内的传播风险。
