In Vitro Efficacy of a Povidone-Iodine Nasal Antiseptic for Rapid Inactivation of SARS-CoV-2 | Infectious Diseases | JAMA Otolaryngology–Head & Neck Surgery | JAMA Network
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    4 Comments for this article
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    Antiseptic mouthwashes in ordinary people " Gives false negative oropharyngeal swabs?"
    Ignazio Condello, PhD | Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, Bari, Italy.
    Antiseptic mouthwashes have been widely used as a standard measure before routine dental treatment, especially preoperatively. They have an essential role in reducing the number of microorganisms in the oral cavity. Recent publications have suggested that rinsing the oral cavity may control and reduce the risk of transmission of SARS-CoV-2.
    Mouthwashes are widely-used solutions due to their ability to reduce the number of microorganisms in the oral cavity. Although there is still no clinical evidence that they can prevent the transmission of SARS-CoV-2, preoperative antimicrobial mouth rinses with chlorhexidine gluconate (CHX), cetylpyridinium chloride (CPC), povidone-iodine (PVP-I), and hydrogen peroxide (H2O2)
    have been recommended to reduce the number of microorganisms in aerosols and drops during oral procedures [1]. We read with great interest the study “In Vitro Efficacy of a Povidone-Iodine Nasal Antiseptic for Rapid Inactivation of SARS-CoV-2” by Samantha Frank et al. where in this controlled in vitro laboratory research study, test media infected with SARS-CoV-2 demonstrated complete inactivation of SARS-CoV-2 by concentrations of PVP-I nasal antiseptic as low as 0.5% after 15 seconds of contact, as measured by a log reduction value of greater than 3 log10 of the 50% cell culture infectious dose of the virus. In Conclusion, povidone-iodine nasal antiseptic solutions at concentrations as low as 0.5% rapidly inactivate SARS-CoV-2 at contact times as short as 15 seconds. Intranasal use of PVP-I has demonstrated safety at concentrations of 1.25% and below and may play an adjunctive role in mitigating viral transmission beyond personal protective equipment [2]. Adequate dental and oral hygiene is practiced daily by ordinary people in particular with antiseptic mouthwashes. We ask in this letter to the editor if the use of antiseptic mouthwashes may give false negative in SARS-CoV-2 RT-PCR test, for oropharyngeal swab in positive patients. This could also be the motivation nasopharyngeal swabs showed higher positive rate than oropharyngeal swabs. The study by Wang X et al. “Comparison of nasopharyngeal and oropharyngeal swabs for SARS-CoV-2 detection in 353 patients received tests with both specimens simultaneously” suggests that nasopharyngeal swabs may be more suitable than oropharyngeal swab [3]. In this context it may be appropriate and crucial to ask the subject before swab whether he has used oral Antiseptic solutions, this would help to solve this question and collect data for further studies.



    References

    [1] Vergara-Buenaventura A, Castro-Ruiz C. Use of mouthwashes against COVID-19 in dentistry. Br J Oral Maxillofac Surg. 2020 Oct;58(8):924-927.

    [2] Frank S, Brown SM, Capriotti JA, Westover JB, Pelletier JS, Tessema B. In Vitro Efficacy of a Povidone-Iodine Nasal Antiseptic for Rapid Inactivation of SARS-CoV-2. JAMA Otolaryngol Head Neck Surg. Published online September 17, 2020.


    [2] Wang X, Tan L, Wang X, et al. Comparison of nasopharyngeal and oropharyngeal swabs for SARS-CoV-2 detection in 353 patients received tests with both specimens simultaneously. Int J Infect Dis. 2020;94:107-109.
    CONFLICT OF INTEREST: None Reported
    READ MORE
    PVP-1
    Isshin Takaoka |
    Povidone -iodine may prevent transmission to lungs from mouth or nose, which was informed at Osaka governor's office August 4.
    Can you confirm the effect to stop the spread of covide-19.
    https://www.katoiin.info/blog/2020/08/post-99-746220.html
    Thank you .
    CONFLICT OF INTEREST: None Reported
    Unrecognized importance
    H Silverstein, MD | Preventive Medicine Center
    This is literally a breakthrough study. the information here inshould be widely dispersed in those areas and nations where the coronavirus infection is still a pandemic or even significantly present. The logic and science is irrefutable and could be remarkably helpful for those with mild-moderate cases early on. H.Robert Silverstein MD
    CONFLICT OF INTEREST: None Reported
    Povidone-Iodine Nasal Antiseptic
    Claude Martin-Mondiere, Medical Doctor Paris |
    I used Povidone-Iodine in almost all forms in Emergency as in Experimental surgery, on practice but also on myself. I was in contact with Chinese people in Houston in December 2019 and I started to use cautiously Povidone-Iodine. Apparently, I was contaminated early with mild signs and short breath I did irrigation of Povidone-Iodine and gave some to a housekeeper, without more treatment we were fine. I did not understand why the advice of nasal irrigation and mouthwash were not prescribed as hand sanitizers. Povidone-Iodine has been used for decades with excellent results to stop contaminations in human practice.
    CONFLICT OF INTEREST: None Reported
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    Original Investigation
    September 17, 2020

    In Vitro Efficacy of a Povidone-Iodine Nasal Antiseptic for Rapid Inactivation of SARS-CoV-2

    Author Affiliations
    • 1University of Connecticut School of Medicine, Farmington
    • 2ProHealth, Ear, Nose and Throat, Farmington, Connecticut
    • 3Veloce BioPharma, Fort Lauderdale, Florida
    • 4The Institute for Antiviral Research at Utah State University, Logan
    • 5Ocean Ophthalmology, Miami, Florida
    JAMA Otolaryngol Head Neck Surg. 2020;146(11):1054-1058. doi:10.1001/jamaoto.2020.3053
    Key Points

    Question  What is the minimum contact time of povidone-iodine (PVP-I) nasal antiseptic required for inactivation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in vitro?

    Findings  In this controlled in vitro laboratory research study, test media infected with SARS-CoV-2 demonstrated complete inactivation of SARS-CoV-2 by concentrations of PVP-I nasal antiseptic as low as 0.5% after 15 seconds of contact, as measured by a log reduction value of greater than 3 log10 of the 50% cell culture infectious dose of the virus.

    Meaning  Intranasal PVP-I rapidly inactivates SARS-CoV-2 and may play an adjunctive role in mitigating viral transmission beyond personal protective equipment.

    Abstract

    Importance  Research is needed to demonstrate the efficacy of nasal povidone-iodine (PVP-I) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

    Objective  To evaluate the in vitro efficacy of PVP-I nasal antiseptic for the inactivation of SARS-CoV-2 at clinically significant contact times of 15 and 30 seconds.

    Interventions  The SARS-CoV-2, USA-WA1/2020 strain, virus stock was tested against nasal antiseptic solutions consisting of aqueous PVP-I as the sole active ingredient. Povidone-iodine was tested at diluted concentrations of 0.5%, 1.25%, and 2.5% and compared with controls. The test solutions and virus were incubated at mean (SD) room temperature of 22 (2) °C for time periods of 15 and 30 seconds.

    Design and Setting  This controlled in vitro laboratory research study used 3 different concentrations of study solution and ethanol, 70%, as a positive control on test media infected with SARS-CoV-2. Test media without virus were added to 2 tubes of the compounds to serve as toxicity and neutralization controls. Ethanol, 70%, was tested in parallel as a positive control and water only as a negative control.

    Main Outcomes and Measures  The primary study outcome measurement was the log reduction value after 15 seconds and 30 seconds of given treatment. Surviving virus from each sample was quantified by standard end point dilution assay, and the log reduction value of each compound was compared with the negative (water) control.

    Results  Povidone-iodine nasal antiseptics at concentrations (0.5%, 1.25%, and 2.5%) completely inactivated SARS-CoV-2 within 15 seconds of contact as measured by log reduction value of greater than 3 log10 of the 50% cell culture infectious dose of the virus. The ethanol, 70%, positive control did not completely inactivate SARS-CoV-2 after 15 seconds of contact. The nasal antiseptics tested performed better than the standard positive control routinely used for in vitro assessment of anti–SARS-CoV-2 agents at a contact time of 15 seconds. No cytotoxic effects on cells were observed after contact with each of the nasal antiseptics tested.

    Conclusions and Relevance  Povidone-iodine nasal antiseptic solutions at concentrations as low as 0.5% rapidly inactivate SARS-CoV-2 at contact times as short as 15 seconds. Intranasal use of PVP-I has demonstrated safety at concentrations of 1.25% and below and may play an adjunctive role in mitigating viral transmission beyond personal protective equipment.

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