Comparison of In Vitro Inactivation of SARS CoV-2 with Hydrogen Peroxide and Povidone-Iodine Oral Antiseptic Rinses

Avinash S Bidra, Jesse S Pelletier, Jonna B Westover, Samantha Frank, Seth M Brown, Belachew Tessema, Avinash S Bidra, Jesse S Pelletier, Jonna B Westover, Samantha Frank, Seth M Brown, Belachew Tessema

Abstract

Purpose: To evaluate the in vitro inactivation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with hydrogen peroxide (H2 O2 ) and povidone-iodine (PVP-I) oral antiseptic rinses at clinically recommended concentrations and contact times.

Materials and methods: SARS-CoV-2, USA-WA1/2020 strain virus stock was prepared prior to testing by growing in Vero 76 cells. The culture media for prepared virus stock was minimum essential medium (MEM) with 2% fetal bovine serum (FBS) and 50 µg/mL gentamicin. Test compounds consisting of PVP-I oral rinse solutions and H2 O2 aqueous solutions were mixed directly with the virus solution so that the final concentration was 50% of the test compound and 50% of the virus solution. Thus PVP-I was tested at concentrations of 0.5%, 1.25%, and 1.5%, and H2 O2 was tested at 3% and 1.5% concentrations to represent clinically recommended concentrations. Ethanol and water were evaluated in parallel as standard positive and negative controls. All samples were tested at contact periods of 15 seconds and 30 seconds. Surviving virus from each sample was then quantified by standard end-point dilution assay and the log reduction value of each compound compared to the negative control was calculated.

Results: After the 15-second and 30-second contact times, PVP-I oral antiseptic rinse at all 3 concentrations of 0.5%, 1.25%, and 1.5% completely inactivated SARS-CoV-2. The H2 O2 solutions at concentrations of 1.5% and 3.0% showed minimal viricidal activity after 15 seconds and 30 seconds of contact time.

Conclusions: SARS-CoV-2 virus was completely inactivated by PVP-I oral antiseptic rinse in vitro, at the lowest concentration of 0.5 % and at the lowest contact time of 15 seconds. Hydrogen peroxide at the recommended oral rinse concentrations of 1.5% and 3.0% was minimally effective as a viricidal agent after contact times as long as 30 seconds. Therefore, preprocedural rinsing with diluted PVP-I in the range of 0.5% to 1.5% may be preferred over hydrogen peroxide during the COVID-19 pandemic.

Keywords: Corona virus; SARS-CoV-2; dental safety; hydrogen peroxide; oral rinse; povidone-iodine.

© 2020 The Authors. Journal of Prosthodontics published by Wiley Periodicals LLC on behalf of American College of Prosthodontists.

References

    1. Volgenant CMC, Persoon IF, de Ruijter RAG, et al: Infection control in dental health care during and after the SARS‐CoV‐2 outbreak. Oral Dis 2020. In press Accessed May 11, 10.1111/odi.13408
    1. Peng X, Xu X, Li Y, et al: Transmission routes of 2019‐nCoV and controls in dental practice. Int J Oral Sci 2020;12:9
    1. Carrouel F, Conte MP, Fisher J, Gonçalves LS, et al: COVID‐19: a recommendation to examine the effect of mouthrinses with β‐Cyclodextrin combined with citrox in preventing infection and progression. J Clin Med 2020;15:9:1126
    1. Zou L, Ruan F, Huang M, et al: SARS‐CoV‐2 viral load in upper respiratory specimens of infected patients. N Engl J Med 2020;382:1177‐1179
    1. Harrel SK, Molinari J: Aerosols and splatter in dentistry: a brief review of the literature and infection control implications. J Am Dent Assoc 2004;135:429‐437
    1. Tessema B, Frank S, Bidra A: SARS‐CoV‐2 Viral inactivation using low dose povidone‐iodine oral rinse‐immediate application for the prosthodontic practice. J Prosthodont 2020. In press Accessed Jun 16, 10.1111/jopr.13207
    1. Bidra AS, Pelletier JS, Westover JB, et al: Rapid in vitro inactivation of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) using povidone‐iodine oral antiseptic rinse. J Prosthodont 2020. In press Accessed Jun 8, 10.1111/jopr.13209
    1. To KK, Tsang OT, Leung WS, et al: Temporal profiles of viral load in posterior oropharyngeal saliva samples and serum antibody responses during infection by SARS‐CoV‐2: an observational cohort study. Lancet Infect Dis 2020;20:565‐574
    1. Chu DK, Akl EA, Duda S, et al: Physical distancing, face masks, and eye protection to prevent person‐to‐person transmission of SARS‐CoV‐2 and COVID‐19: a systematic review and meta‐analysis. Lancet 2020;395(10242):P1973‐1987
    1. ADA Interim Guidance for Minimizing Risk of COVID‐19 Transmission . . Accessed May 28, 2020.
    1. The Centers for Disease Control and Prevention (CDC) . Interim infection prevention and control guidance for dental settings during the COVID‐19 response. Accessed May 28, 2020.
    1. O'Donnell VB, Thomas D, Stanton R, et al: Potential role of oral rinses targeting the viral lipid envelope in SARS‐CoV‐2 infection. Function 2020. In press Accessed May 14, 10.1093/function/zqaa002.
    1. Gui D, Pepe G, Magalini S: Just one more hygiene practice in COVID‐19. Eur Rev Med Pharmacol Sci 2020;24:3438‐3439
    1. Frank S, Capriotti J, Brown SM, et al: Povidone‐iodine use in sinonasal and oral cavities: a review of safety in the COVID‐19 era. Ear Nose Throat J 2020. In press Accessed Jun 10, 10.1177/0145561320932318.
    1. Foley TP Jr: The relationship between autoimmune thyroid disease and iodine intake: a review. Endokrynol Pol 1992;43:53‐69
    1. Furudate S, Nishimaki T, Muto T: 125I uptake competing with iodine absorption by the thyroid gland following povidone‐iodine skin application. Exp Anim 1997;46:197‐202
    1. Gray PEA, Katelaris CH, Lipson D: Recurrent anaphylaxis caused by topical povidone iodine (Betadine). J Paediatr Child Health 2013;49:506‐507
    1. Walsh LJ: Safety issues relating to the use of hydrogen peroxide in dentistry. Aust Dent J. 2000;45:257‐269
    1. Caruso AA, Del Prete A, Lazzarino AI: Hydrogen peroxide and viral infections: a literature review with research hypothesis definition in relation to the current covid‐19 pandemic. Med Hypotheses 2020. In press Accessed Jun 1, 10.1016/j.mehy.2020.109910
    1. Zanelli M, Ragazzi M, De Marco L: Chemical gastritis and colitis related to hydrogen peroxide mouthwash. Br J Clin Pharmacol 2017;83:427‐428
    1. Kraus FW, Perry WI, Nickerson JF: Salivary catalase and peroxidase values in normal subjects and in persons with periodontal disease. Oral Surg Oral Med Oral Pathol 1958;11:95‐102
    1. Reed LJ, Muench H: A simple method of estimating fifty percent endpoints. Am J Epidemiol 1938;27:493‐497
    1. Osso D, Kanani N: Antiseptic mouth rinses: an update on comparative effectiveness, risks and recommendations. J Dent Hyg 2013;87:10‐18
    1. Kariwa H, Fujii N, Takashima I: Inactivation of SARS coronavirus by means of povidoneiodine, physical conditions and chemical reagents. Dermatology 2006;212:119‐23
    1. Eggers M, Koburger‐Janssen T, Eickmann M, et al: In vitro bactericidal and virucidal efficacy of povidone‐iodine gargle/mouthwash against respiratory and oral tract pathogens. Infect Dis Ther 2018;7:249‐259
    1. Madan PD, Sequeira PS, Shenoy K, et al: The effect of three mouthwashes on radiation‐induced oral mucositis in patients with head and neck malignancies: a randomized control trial. J Cancer Res Ther 2008;4:3‐8
    1. World Health Organization . Essential medicines and health products. Accessed June 20, 2020.
    1. Kovesi G: The use of betadine antiseptic in the treatment of oral surgical, paradontological and oral mucosal diseases. Fogorvosi szemle 1999;92:243‐250
    1. Kanagalingam J, Feliciano R, Hah JH, et al: Practical use of povidone‐iodine antiseptic in the maintenance of oral health and in the prevention and treatment of common oropharyngeal infections. Version 2. Int J Clin Pract 2015;69:1247‐1256
    1. Fine PD: A clinical trial to compare the effect of two antiseptic mouthwashes on gingival inflammation. J Hosp Infect 1985;6:189‐193

Source: PubMed

Sponsors en medewerkers

Medische omstandigheden

Geneesmiddelinterventies

3
Abonneren