Clinical evaluation of antiseptic mouth rinses to reduce salivary load of SARS-CoV-2

Abstract

Most public health measures to contain the COVID-19 pandemic are based on preventing the pathogen spread, and the use of oral antiseptics has been proposed as a strategy to reduce transmission risk. The aim of this manuscript is to test the efcacy of mouthwashes to reduce salivary viral load in vivo. This is a multi-centre, blinded, parallel-group, placebo-controlled randomised clinical trial that tests the efect of four mouthwashes (cetylpyridinium chloride, chlorhexidine, povidone-iodine and hydrogen peroxide) in SARS-CoV-2 salivary load measured by qPCR at baseline and 30, 60 and 120 min after the mouthrinse. A ffth group of patients used distilled water mouthrinse as a control. Eighty-four participants were recruited and divided into 12¿15 per group. There were no statistically signifcant changes in salivary viral load after the use of the diferent mouthwashes. Although oral antiseptics have shown virucidal efects in vitro, our data show that salivary viral load in COVID-19 patients was not afected by the tested treatments. This could refect that those mouthwashes are not efective in vivo, or that viral particles are not infective but viral RNA is still detected by PCR. Viral infectivity studies after the use of mouthwashes are therefore required. (https://clinicaltrials.gov/ct2/ show/NCT04707742; Identifer: NCT04707742