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Role of povidone iodine in reducing cross-infection and protecting healthcare workers during the COVID-19 pandemic |
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Role of povidone iodine in reducing cross-infection and protecting healthcare workers during the COVID-19 pandemic

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The Coronavirus disease 2019, or COVID-19, which reportedly originated from Wuhan, China, was declared as a pandemic on March 11, 2020 by the World Health Organization. The viral illness poses a significant threat to healthcare workers. Besides this, the non-infected hospitalized patients are also at a significant risk. A report had suggested that 41% of the patients at a center had suspected nosocomial transmission of the infection.

Saliva has been reported to have a high viral load in COVID-19 with estimates of up to 1.2×108 infective copies/mL when assessed at the time of admission. PCR assays have shown that the nasopharynx carries a higher viral load than the oropharynx.

Working towards minimizing or reducing the viral titres in saliva and nasal mucous from COVID-19 patients could play a major role in curbing the transmission of the disease as well as cross-infection from patients to healthcare workers and from the health professionals to patients.

Povidone-iodine (PVP-I) is an antimicrobial complex which has higher virucidal potential compared to some other antiseptic agents such as chlorhexidine and benzalkonium chloride. The agent has shown potential in vitro activity against SARS-CoV and MERS-CoV. SARS-CoV-2, which causes COVID-19, is similar to SARS-CoV.

PVP-I gargle has been shown to be well tolerated in comparison with other gargled antiseptic agents in common use. In a publication dated May 4, 2020, Kirk-Bayley and colleagues suggest the use of PVP-I in patients with presumed/confirmed COVID-19 as well as in the healthcare professionals in close contact with such patients. It should also be used by patients undergoing procedures in or around the mouth and nose and the healthcare professionals who are carrying out those procedures. Evidence indicates that application of PVP-I to the nasal and oral mucosae of patients with COVID-19 could have a potential role in reducing the viral load in these areas, thus reducing the risk of transmission. Similarly, prophylactic use of PVP-I among healthcare workers could help in reducing transmission.

The authors of the paper thus suggest the use of PVP-I among patients as well as healthcare workers during the ongoing pandemic. Oral use of PVP-I could help in the disinfection of the oral cavity. It is interesting to note that the American Dental Association’s interim guidelines aimed at limiting the risk of COVID-19 transmission also incorporate the use of a pre-operative PVP-I mouthwash.

Source: Kirk-Bayley J, Sunkaraneni VS, Challacombe SJ. The use of Povidone Iodine nasal spray and mouthwash during the current COVID-19 pandemic may reduce cross infection and protect healthcare workers. SSRN. 2020. Available at: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3563092.

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