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The Use of On-Demand Aqueous Chlorine Dioxide Mouthwash Does Not Impact SARS-CoV-2 Salivary Viral Titer Levels
TAKE-HOME MESSAGE
- This multicenter, randomized, open-label, placebo-controlled clinical trial examined the impact of on-demand aqueous chlorine dioxide (OACD) mouthwash on SARS-CoV-2 salivary viral titers in patients with mild COVID-19. The patients were divided into three groups based on the mouthwash used: 0.01% OACD mouthwash, 0.05% cetylpyridinium chloride (CPC) mouthwash, and placebo (water). A significant reduction in salivary viral titers was noted 10 minutes following the use of CPC mouthwash, but no impact was observed at 30- and 60-minute time points. Compared with placebo, the use of OACD mouthwash did not reduce salivary viral titers at 10-, 30-, and 60-minute time points.
- Compared with placebo and OACD mouthwash, CPC mouthwash shows promise in reducing SARS-CoV-2 salivary viral titers and has to be tested across settings and populations in future studies.
abstract
This abstract is available on the publisher's site.
Access this abstract nowObjectives
The established effect of cetylpyridinium chloride (CPC) mouthwash on SARS-CoV-2 viral titers is unclear. No clinical trial has examined the impact of on-demand aqueous chlorine dioxide mouthwash on SARS-CoV-2 viral titer.
Methods
In this multicenter, 3-armed, randomized, open-label, placebo-controlled clinical trial involving mildly symptomatic COVID-19 patients, we randomly assigned them to receive 20 mL of 0.05% CPC, 10 mL of 0.01% on-demand aqueous chlorine dioxide, or 20 mL of purified water as a placebo mouthwash in a 1:1:1 ratio. The primary measurement was the SARS-CoV-2 viral titer in saliva, evaluated by a mixed-effects linear regression model.
Results
49 patients received CPC mouthwash (n=16), on-demand aqueous chlorine dioxide mouthwash (n=16), and placebo (n=17) between January 14, 2024, and February 20, 2024. 0.05% CPC mouthwash significantly reduced salivary viral titer at 10 minutes postuse (-0.97 log10 PFU/mL; 95% CI, -1.64 to -0.30; P = .004), while no such effect was observed at 30 minutes (difference vs placebo, -0.26 log10 PFU/mL; 95% CI, -0.92 to 0.40; P = .435) or 60 minutes (difference vs. placebo, -0.05 log10 PFU/mL; 95% CI, -0.68 to 0.58; P = .877). 0.01% on-demand chlorine dioxide mouthwash did not reduce salivary viral titer at 10 minutes, 30 minutes, or 60 minutes compared to placebo.
Conclusions</3>
10 minutes after using a 0.05% CPC mouthwash, the salivary viral titer of SARS-CoV-2 decreased compared to placebo. 0.01% on-demand aqueous chlorine dioxide mouthwash and placebo had no significant difference in SARS-CoV-2 viral titers.
Additional Info
Disclosure statements are available on the authors' profiles: