The aim of an article published in the Ear, Nose & Throat Journal was to review the efficacy of povidone-iodine (PVP-I) against coronaviruses and its potential efficacy against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

This study entailed searches from the PubMed and Cochrane Databases and included independent reviews of all citations and published protocols for nasal and oral PVP-I use in the context of the coronavirus disease 2019 (COVID-19). 

The findings revealed that PVP-I can be safely used topically, in the nasal cavity for up to 5 months and the oral cavity for 6 months. When used at concentrations below 2.5%, this solution does not affect the ciliary beat frequency and does not cause pathological alterations of the nasal epithelium, upper respiratory, or mucosal cells. 

The topical use of PVP-I is well tolerated amongst most adults or children. In addition, PVP-I rarely causes allergy or contact sensitivity. When used at 5% concentration, PVP-I does not precipitate clinical thyroid disease.

The solution was found to have a potent virucidal activity and inactivates coronaviruses like the SARS-CoV-2 and Middle East Respiratory Syndrome (MERS). The recommended concentration for topical application in the nasal cavity is 1.25% and as a mouth rinse is 2.5%. This modality can rapidly inactivate coronaviruses when applied for a short time span of 15 seconds.

Although the in vitro efficacy has not yet been demonstrated through clinical trials, available evidence suggests that PVP-I can effectively inactivate and eradicate SARS-CoV-2 in the nasal cavity, nasopharynx, oral cavity, and oropharynx.

Source: Ear, Nose & Throat Journal. 2020;99(9):586-593. doi:10.1177/0145561320932318