Effectiveness of mouth antiseptics in reducing the viral load of SARS-CoV-2 load in saliva? A systematic review of clinical trials
DOI:
https://doi.org/10.53660/PRW-2278-4210Palavras-chave:
COVID-19, SARS-CoV-2, Mouthwashes, In VivoResumo
This systematic review assessed the effect of mouthwashes on reducing the SARS-CoV-2 viral load in the saliva of infected patients. Fifteen electronic databases were searched using the terms "Mouthwash", "Viral Load", and "COVID-19". Only clinical trials were considered, with no language or publication year restrictions. Bias risk was assessed using the Cochrane tool (Rob 2.0) for randomized clinical trials and non-randomized trials (ROBINS-I). The quality of evidence was evaluated using the GRADE system. After the search, 1,102 references were identified and assessed for eligibility criteria. Among these, 34 were selected, and after a thorough analysis, only six were included. The mouthwashes evaluated included 1% hydrogen peroxide, iodopovidone, cetylpyridinium chloride, and chlorhexidine. The results indicated that iodopovidone, chlorhexidine, and cetylpyridinium chloride performed better compared to other options. In conclusion, the use of mouthwashes appears to be effective in reducing the SARS-CoV-2 viral load in saliva.
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Andrews JC, et al, 2013. GRADE guidelines: 15. Going from evidence to recommendation - Determinants of a recommendation direction and strength. J Clin Epidemiol.66(7):726–35.
Bhat TA, et al, 2020. An Animal Model of Inhaled Vitamin E Acetate and EVALI-like Lung Injury. N Engl J Med. 382(12):1175–7.
Cavalcante-Leão BL, et al, 2021. Is there scientific evidence of the mouthwashes effectiveness in reducing viral load in Covid-19? A systematic review. J Clin Exp Dent.Feb 1; 13(2): e179-e189
Danion F, et al, 2020. The Good, the Bad, and the Hoax: When publication instantaneously impacts treatment strategies for COVID-19. Antimicrob Agents Chemother. 64(8):19–21.
Elzein R, et al, 2021. In vivo evaluation of the virucidal efficacy of Chlorhexidine and Povidone-iodine mouthwashes against salivary SARS-CoV-2. A randomized-controlled clinical trial. J Evid Based Dent Pract.21(3): 101584.
Etievant S, et al, 2021. Performance Assessment of SARS-CoV-2 PCR Assays Developed by WHO Referral Laboratories. J Clin Med. 2020;9(6):1871.
Ferrer, M.D., et al, 2021. Clinical evaluation of antiseptic mouth rinses to reduce salivary load of SARS-CoV-2. Sci Rep 11, 24392.
Gottsauner, M.J., et al, 2020. A prospective clinical pilot study on the effects of a hydrogen peroxide mouthrinse on the intraoral viral load of SARS-CoV-2. Clin Oral Invest 24, 3707–3713.
Higgins JPT, et al, 2019. Cochrane handbook for systematic reviews of interventions. Cochrane Handb Syst Rev Interv.1–694.
Institute of German Dentists. System of standard procedures for dental practices during the coronavirus pandemic. On the Internet: https://www.idz.institute/publikationen/sonstiges/system-von-standardvorgehensweisen-fuerzahnarztpraxen-waehrend-der-coronavirus-pandemie.html; As of 24.04.2020
Kawana R, et al, 1997. Inactivation of Human viruses by Povidone-Iodine in Comparison with Other Antiseptics. Dermatology.195(2):29-35.
Kim ES, et al, 2020. Clinical course, and outcomes of patients with severe acute respiratory syndrome coronavirus 2 infection: A preliminary report of the first 28 patients from the korean cohort study on COVID-19. J Korean Med Sci.35(13):1–12.
Li Q, et al, 2020. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected Pneumonia. N Engl J Med. 382(13):1199–207.
Meister TL, et al, 2020. Virucidal efficacy of different oral rinses against severe acute respiratory syndrome Coronavirus 2. J Infect Dis.222(8):1289–92.
Moher D, et al, 2011. PRISMA statement. Epidemiology. 22(1):128.
O’Donnell VB, et al, 2020. Potential Role of Oral Rinses Targeting the Viral Lipid Envelope in SARS-CoV-2 Infection. Function. 1(1):1–12.
Peng, X., et al, 2020. Transmission routes of 2019-nCoV and controls in dental practice. Int J Oral Sci.12-9.
Popkin DL, et al, 2017. Cetylpyridinium Chloride (CPC) Exhibits Potent, Rapid Activity Against Influenza Viruses in vitro and in vivo. Pathog Immun.2(2):252-269.
Rao SN, et al, 2020. Narrative Systematic Review of the Clinical Utility of Cycle Threshold Values in the Context of COVID-19. Infect Dis Ther. 9(3):573–86.
Recomendações AMIB/CFO para enfrentamento da Covid-19 na Odontologia. Disponível em: https://website.cfo.org.br/wp-content/uploads/2020/07/Recomendac%CC%A7o%CC%83es-AMIB-CFO-Covid-19-atualizada-.pdf. As of 24.04.2020
Seneviratne, C.J., et a, 202l. Efficacy of commercial mouth-rinses on SARS-CoV-2 viral load in saliva: randomized control trial in Singapore. Infection. 49, 305–311.
Wang D, et al, 2020. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China. JAMA. 323(11):1061–1069. doi:10.1001/jama.2020.1585
Xu H, et al, 2020. High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa. Int J Oral Sci. 12(1):1–5.
Yousefimanesh, H., et al., 2022. The Antibacterial Analysis of Alcohol-Free and Alcohol-Based Chlorhexidine Mouthwashes Against Oral Bacteria. Avicenna J Clin Microbiol Infect, 9(1), 16-20.
Zhou, P., et al. 2020. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature 579, 270–273.