SARS-CoV-2, the virus wreaking havoc across the globe by causing the COVID 19 pandemic, is quite similar to the SARS-CoV. Povidone iodine (PVP-I), a potent antimicrobial iodine complex, has been shown in previous in vitro studies to be highly effective against SARS-CoV. Treatment of SARS-CoV with different preparations of PVP-I was found to decrease the viral activity to undetectable levels.¹

It is well known that the oropharynx and nasopharynx are potential target sites of the SARS-CoV-2 virus and that the saliva carries a high viral load to the extent of 1.2 × 108 infective copies/per ml.²

Even a small amount of saliva can contaminate the instruments used in healthcare practice with several thousands of infectious viral particles.

Additionally, evidence suggests that viral shedding may begin even before the appearance of the first symptoms.³

Reducing the risk of transmission thus becomes important, especially in healthcare settings.

PVP-I is a potential antiviral compound with better antiviral activity in comparison with other antiseptics, such as chlorhexidine.⁴

A recent study evaluated the tolerability of PVP-I in patients and in healthcare workers. Patients were advised to put PVP-I drops in nose and rinse mouth with PVP-I gargle before examinations. For endoscopic procedure (nasal and throat), nasal douching and gargling were advised to be initiated one day prior. Douching and rinsing were to be repeated before procedures. Overall, 315 patients underwent nose and throat endoscopies. All of them, except 7, were comfortable with PVP-I gargles and nasal drops. Seventeen healthcare workers used the PVP-I nasal drops and gargles. The patients and healthcare workers tolerated PVP-I well and no allergy was noted. Investigators thus proposed the use of PVP-I in healthcare workers and their patients to minimize the risk of transmission besides the recommended PPE.⁴

Use of PVP-I during the ongoing COVID 19 pandemic could potentially limit the spread of infection from patients to healthcare workers and vice versa.

References

1. Kariwa H, Fujii N, Takashima I. Inactivation of SARS Coronavirus by Means of Povidone-Iodine, Physical Conditions and Chemical Reagents. Dermatology 2006;212:119–123.
2. To KK-W, Tsang OT-Y, Yip CC-Y, et al. Consistent Detection of 2019 Novel Coronavirus in Saliva. Clinical Infectious Diseases 2020;71(15):841–843.
3. He X, Lau EHY, Wu P, et al. Temporal dynamics in viral shedding and transmissibility of COVID-19. Nature Medicine 2020;26:672–675.
4. Khan MM, Parab SR, Paranjape M. Repurposing 0.5% povidone iodine solution in otorhinolaryngology practice in Covid 19 pandemic. American Journal of Otolaryngology 2020;41(5):102618.