Dataset Information

Effects of hypertonic alkaline nasal irrigation on COVID-19.

ABSTRACT:

Objective

The causative agent of COVID-19 is a novel member of coronaviridaes, SARS-CoV-2. It has been reported that the spike (S) protein of SARS-CoV-2 is responsible of infectivity. The S protein is demonstrated to be inactivated under environmental condition, such as hypertonicity and alkaline pH. The aim of the study was to investigate the effect of hypertonic alkaline nasal irrigation (HANI) on SARS-CoV-2.

Methods

Sixty patients divided into two groups. The patients in Group 1 used hydroxychloroquine (HCQ), and the patients in Group 2 used HCQ and HANI. Nasopharyngeal samples were collected at the beginning, on 3rd and 7th day of the PCR test positivity. The nasopharyngeal viral load (NVL) changes analyzed with quantitative PCR.

Results

NVL decrease in weekly period was statistically significant for both groups, when the difference between NVL day 0 and 3rd in Group 1 and NVL difference between day 0 and 3rd in Group 2 were compared. The difference between Groups 1 and 2 in terms of NVL change was statistically significant (P < 0.05).

Conclusion

We demonstrated a significant decrease in nasopharyngeal SARS-CoV-2 load with HANI solution and suggest that HANI may be promising modality for the COVID-19 treatment.

Level of evidence

IB.

SUBMITTER: Yilmaz YZ

PROVIDER: S-EPMC8661954 | biostudies-literature | 2021 Dec

REPOSITORIES: biostudies-literature

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Publications

Effects of hypertonic alkaline nasal irrigation on COVID-19.

Yilmaz Yetkin Zeki YZ Yilmaz Begum Bahar BB Ozdemir Yusuf Emre YE Kocazeybek Bekir Sami BS Karaali Ridvan R Çakan Doğan D Ozdogan Hasan Ahmet HA Batioglu-Karaaltin Aysegul A

Laryngoscope investigative otolaryngology 20211119 6

<h4>Objective</h4>The causative agent of COVID-19 is a novel member of coronaviridaes, SARS-CoV-2. It has been reported that the spike (S) protein of SARS-CoV-2 is responsible of infectivity. The S protein is demonstrated to be inactivated under environmental condition, such as hypertonicity and alkaline pH. The aim of the study was to investigate the effect of hypertonic alkaline nasal irrigation (HANI) on SARS-CoV-2.<h4>Methods</h4>Sixty patients divided into two groups. The patients in Group ...[more]

PMID: 34909468

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Project description:BackgroundIn a previous pilot randomised controlled trial conducted on UK adults, we found that hypertonic saline nasal irrigation and gargling (HSNIG) reduced common cold symptoms, the need for over-the-counter medications, viral shedding, and the duration and transmission of the illness. It is unclear whether HSNIG improves outcomes of the coronavirus disease 2019 (COVID-19). Hypertonic saline can be prepared and HSNIG performed at home, making it a safe and scalable intervention, particularly well-suited for low- and middle-income countries.MethodsWe conducted a pragmatic randomised controlled trial in Pakistan on adults with suspected or confirmed COVID-19, initially within 48 hours of symptom onset, later extended to within five days due to recruitment challenges. Participants were randomised to one of two groups: the intervention group received instructions on preparing a 2.6% hypertonic saline solution for HSNIG, while the control group was instructed on performing ablution for Muslim prayers (wudu), which involves nasal washing and gargling with tap water. Our primary outcome was the time to symptom resolution, measured by two consecutive days of scoring zero on relevant questions from the validated, self-reported, adapted short form of the Wisconsin Upper Respiratory Symptom Survey (WURSS-24). Secondary outcomes included the severity of all symptoms, the severity and time to resolution of individual symptoms, health care contacts (GP/physician, emergency contacts), hospital attendance (and length of stay if admitted), over-the-counter (OTC) medication (frequency and cost), and transmission to household contacts. The analysis was conducted on an intention-to-treat basis. Logistic regression was used to calculate adjusted odds ratios (aORs) of improvement and Cox regression to calculate adjusted hazard ratios (aHRs) for the time to improvement with accompanying 95% confidence intervals (CIs).ResultsWe randomised 576 people: 279 to the HSNIG group and 297 to the control group. Among those, 10 out of 279 (3.6%) in the HSNIG had symptom resolution, compared with 11 out of 297 (3.7%) in the control group (aOR = 1.20, 95% CI = 0.46- 3.22). The time-to-event analysis also showed no significant benefit (aHR = 1.23, 95% CI = 0.51-2.97). Excluding the 127 participants with no data on the primary outcome (who did not complete the study), 10 out of 222 (4.5%) in the HSNIG group had symptom resolution, compared to 11 out of 227 (4.8%) in the control group.ConclusionsHSNIG was not effective for individuals with suspected or confirmed COVID-19 who began the intervention within five days of symptoms onset and therefore cannot be recommended for use. Further investigation is needed for interventions started within 48 hours of illness onset.RegistrationClinicalTrials.gov (NCT05104372).

Dataset Information

Effects of hypertonic alkaline nasal irrigation on COVID-19.

Objective

Methods

Results

Conclusion

Level of evidence

Publications

Effects of hypertonic alkaline nasal irrigation on COVID-19.

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