While India reported a decline of 40% in new COVID-19 infections in the week ending March 20, 2022, cases increased by 4% in a week globally.¹

This pandemic, which has turned our lives upside down over the past 2 years, is far from over, and there is a need to continue following the preventive measures in order to check the spread of SARS-CoV-2. It is clearly known now that this virus is transmitted among humans through infected respiratory droplets, saliva, or by direct contact with contaminated surfaces.² Airborne transmission of SARS-CoV-2 also cannot be ignored.³

An individual can easily get infected by inhaling the aerosols generated on exhaling, speaking, shouting, sneezing, or coughing, by an infected person. Therefore, our major defence in such a situation is physical distancing, use of masks, limiting direct contact with people, use of physical barriers, adequate indoor ventilation and air filtration, and hand washing.³ 

It has been shown that the viral load is quite high in the nasopharynx, saliva and throat.⁴ Saliva can act as a potent source of transmission. Adequate oral and throat hygiene are key to restrict the transmission of this virus, thus justifying the need for an antiviral mouthwash/gargle that can decrease the oral viral load and help check the virus spread.² 

Povidone-iodine (PVP-I), an antiseptic agent, has been shown to be effective against coronavirus.² This broad spectrum antimicrobial agent has been shown to have virucidal potential and decreases the viral particles in saliva as well as the respiratory droplets.² PVP-I has also been reported to have higher virucidal activity compared to several other commonly used antiseptic agents.⁵ Now there is clinical evidence as well showing early viral clearance among COVID-19 patients with the use of PVP-I mouthwash.⁴ 

Recently, a randomized controlled trial by Choudhury and colleagues included 606 COVID patients who were divided into two groups. Group A used PVP-I mouthwash/gargle, nasal drops and eye drops every 4 hours for 4 weeks besides receiving symptomatic treatment as needed. Group B received mouthwash/gargle, nasal wash and eye wash with lukewarm water besides symptomatic treatment based on requirement. RT-PCR test was done on 3rd, 5th and 7th day. In group A, only 2.64% patients were RT-PCR positive on the 7th day while in group B, 70.3% patients were positive on day 7. Additionally, patients using PVP-I formulations had a considerable reduction in mortality, morbidity and hospital and financial burden.⁵ 

Use of PVP-I mouthwash, to maintain appropriate oral hygiene, is a simple, quick, safe, and cost-effective approach in the current scenario to prevent community transmission of SARS-CoV-2.^2,5 Its routine use, in the hospital and household environment, can help reduce the viral load among infected individuals, thus curbing the spread of the pandemic.

References

1. Weekly Covid deaths drop below 200, lowest in 2 years. Available from: https://health.economictimes.indiatimes.com/news/industry/weekly-covid-deaths-drop-below-200-lowest-in-2-years/90343449. Accessed on March 21, 2022.
2. Chopra A, Sivaraman K, Radhakrishnan R, et al. Can povidone iodine gargle/mouthrinse inactivate SARS-CoV-2 and decrease the risk of nosocomial and community transmission during the COVID-19 pandemic? An evidence-based update. Jpn Dent Sci Rev. 2021 Nov; 57: 39-45.
3. Greenhalgh T, Jimenez JL, Prather KA, et al. Ten scientific reasons in support of airborne transmission of SARS-CoV-2. Lancet. 2021 May 1;397(10285):1603-1605.
4. Mohamed NA, Baharom N, Sulaiman WSW, et al. Early viral clearance among COVID-19 patients when gargling with povidone-iodine and essential oils – a clinical trial. Available from: https://www.medrxiv.org/content/10.1101/2020.09.07.20180448v1.full.pdf. Accessed on February 28, 2022.
5. Choudhury MIM, Shabnam N, Ahsan T, et al. Effect of 1%Povidone Iodine Mouthwash/Gargle, Nasal and Eye Drop in COVID-19 patient. Bioresearch Communications 2021;7(1):919-23.