Could nasal irrigation and oral rinse reduce the risk for COVID-19 infection?
Manuele Casale, Vittorio Rinaldi, Lorenzo Sabatino, Antonio Moffa, Massimo Ciccozzi, Manuele Casale, Vittorio Rinaldi, Lorenzo Sabatino, Antonio Moffa, Massimo Ciccozzi
Abstract
Public health measures are essential to protect against COronaVIrus Disease 2019 (COVID-19). The nose and the mouth represent entry portals for the COVID 19. Saline Nasal Irrigations (SNIs) can reduce the viral load in the nasal cavities. Oral rinse with antimicrobial agents is efficacious in reducing the viral load in oral fluids. We advocate the inclusion of SNIs and ethanol oral rinses as additional measures to the current public health measures, to prevent and control the transmission of any respiratory infectious disease, including COVID-19.
Keywords: COVID-19 infection; oral rinses; prevention; saline nasal irrigations.
Conflict of interest statement
Declaration of conflicting interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: M.C. is inventor of Spray-sol device. A.M. has a grant from Steve Jones S.R.L. and BRIO S.R.L. for research about Spray-sol device. All other authors report no conflict of interest.
References
- Remuzzi A, Remuzzi G. (2020) COVID-19 and Italy: What next? The Lancet. Epub ahead of print 13 March. DOI: 10.1016/S0140-6736(20)30627-9.
- Spina S, Marrazzo F, Migliari M, et al. (2020) The response of Milan’s Emergency Medical System to the COVID-19 outbreak in Italy. The Lancet 395(10227): e49–e50.
- Rothan HA, Byrareddy SN. (2020) The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. Journal of Autoimmunity 109: 102433.
- Brewster DJ, Chrimes N, Do TB, et al. (2020) Consensus statement: Safe Airway Society principles of airway management and tracheal intubation specific to the COVID-19 adult patient group. Medical Journal of Australia 212: 472–481.
- Yan Y, Chen H, Chen L, et al. (2020) Consensus of Chinese experts on protection of skin and mucous membrane barrier for health-care workers fighting against coronavirus disease 2019. Dermatologic Therapy. Epub ahead of print 13 March. DOI: 10.1111/dth.13310.
- Chilvers MA, McKean M, Rutman A, et al. (2001) The effects of coronavirus on human nasal ciliated respiratory epithelium. European Respiratory Journal 18(6): 965–970.
- Slapak I, Skoupá J, Strnad P, et al. (2008) Efficacy of isotonic nasal wash (seawater) in the treatment and prevention of rhinitis in children. Archives of Otolaryngology–Head & Neck Surgery 134(1): 67–74.
- Tano L, Tano K. (2004) A daily nasal spray with saline prevents symptoms of rhinitis. Acta Oto-Laryngologica 124(9): 1059–1062.
- Ramalingam S, Graham C, Dove J, et al. (2019) A pilot, open labelled, randomised controlled trial of hypertonic saline nasal irrigation and gargling for the common cold. Scientific Reports 9(1): 1015.
- Ramalingam S, Cai B, Wong J, et al. (2018) Antiviral innate immune response in non-myeloid cells is augmented by chloride ions via an increase in intracellular hypochlorous acid levels. Scientific Reports 8(1): 13630.
- Casale M, Moffa A, Cassano M, et al. (2018) Saline nasal irrigations for chronic rhinosinusitis: From everyday practice to evidence-based medicine. An update. International Journal of Immunopathology and Pharmacology 32: 2058738418802676.
- Meiller TF, Silva A, Ferreira SM, et al. (2005) Efficacy of Listerine antiseptic in reducing viral contamination of saliva. Journal of Clinical Periodontology 32(4): 341–346.
- Siddharta A, Pfaender S, Vielle NJ, et al. (2017) Virucidal activity of World Health Organization-recommended formulations against enveloped viruses, including Zika, Ebola, and emerging coronaviruses. Journal of Infectious Diseases 215(6): 902–906.
Source: PubMed