Comparison of In Vitro Inactivation of SARS CoV‐2 with Hydrogen Peroxide and Povidone‐Iodine Oral Antiseptic Rinses

Abstract

Purpose To evaluate the in vitro inactivation of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) with hydrogen peroxide (H2O2) and povidone‐iodine (PVP‐I) oral antiseptic rinses at clinically recommended concentrations and contact times. Materials and Methods SARS‐CoV‐2, USA‐WA1/2020 strain virus stock was prepared prior to testing by growing in Vero 76 cells. The culture media for prepared virus stock was minimum essential medium (MEM) with 2% fetal bovine serum (FBS) and 50 µg/mL gentamicin. Test compounds consisting of PVP‐I oral rinse solutions and H2O2 aqueous solutions were mixed directly with the virus solution so that the final concentration was 50% of the test compound and 50% of the virus solution. Thus PVP‐I was tested at concentrations of 0.5%, 1.25%, and 1.5%, and H2O2 was tested at 3% and 1.5% concentrations to represent clinically recommended concentrations. Ethanol and water were evaluated in parallel as standard positive and negative controls. All samples were tested at contact periods of 15 seconds and 30 seconds. Surviving virus from each sample was then quantified by standard end‐point dilution assay and the log reduction value of each compound compared to the negative control was calculated. Results After the 15‐second and 30‐second contact times, PVP‐I oral antiseptic rinse at all 3 concentrations of 0.5%, 1.25%, and 1.5% completely inactivated SARS‐CoV‐2. The H2O2 solutions at concentrations of 1.5% and 3.0% showed minimal viricidal activity after 15 seconds and 30 seconds of contact time. Conclusions SARS‐CoV‐2 virus was completely inactivated by PVP‐I oral antiseptic rinse in vitro, at the lowest concentration of 0.5 % and at the lowest contact time of 15 seconds. Hydrogen peroxide at the recommended oral rinse concentrations of 1.5% and 3.0% was minimally effective as a viricidal agent after contact times as long as 30 seconds. Therefore, preprocedural rinsing with diluted PVP‐I in the range of 0.5% to 1.5% may be preferred over hydrogen peroxide during the COVID‐19 pandemic.

Airborne Aerosolized Mouse Cytomegalovirus From Common Otolaryngology Procedures: Implications for COVID‐19 Infection

“…37 On the basis of an in vitro study demonstrating inactivation of SARS-CoV-2 and a small case series showing a significant reduction in COVID-19 viral loads in 2 of 4 patients using a povidone-iodine mouthwash, we have started to use 0.5% povidone-iodine irrigation during our mastoidectomy procedures. 38,39 Samplers that are commonly used for bioaerosol sampling are not designed to collect nanosized viral aerosols. 14…”

Pharmaceutical assessment of polyvinylpyrrolidone (PVP): As excipient from conventional to controlled delivery systems with a spotlight on COVID-19 inhibition

“…The H2 O2 solutions at concentrations of 1.5% and 3.0% showed minimal viricidal activity after 15 s and 30 s of contact time. [ 199 ] …”

Rapid Review of SARS-CoV-1 and SARS-CoV-2 Viability, Susceptibility to Treatment, and the Disinfection and Reuse of PPE, Particularly Filtering Facepiece Respirators

“…Elimination of the virus from a number of surfaces can be rapidly achieved with chemical treatment. Virucidal activity against SARS-CoV-1 and/or SARS-CoV-2 with a ≥4 log 10 reduction has been shown for a variety of chemicals including: povidone-iodine solution (≥0.5%) [ 73 , 74 ], formaldehyde (4%) [ 33 , 66 ], ethanol (≥70%) [ 37 , 39 , 74 , 75 , 76 ], sodium hypochlorite (10% [ 33 ] or household bleach 1:49 [ 37 ]), and benzalkonium chloride (0.1%) [ 37 ]. However, liquid hydrogen peroxide at 3% had minimal viricidal effect against SARS-CoV-2 after 30 seconds of contact [ 74 ].…”

“…Virucidal activity against SARS-CoV-1 and/or SARS-CoV-2 with a ≥4 log 10 reduction has been shown for a variety of chemicals including: povidone-iodine solution (≥0.5%) [ 73 , 74 ], formaldehyde (4%) [ 33 , 66 ], ethanol (≥70%) [ 37 , 39 , 74 , 75 , 76 ], sodium hypochlorite (10% [ 33 ] or household bleach 1:49 [ 37 ]), and benzalkonium chloride (0.1%) [ 37 ]. However, liquid hydrogen peroxide at 3% had minimal viricidal effect against SARS-CoV-2 after 30 seconds of contact [ 74 ]. Chemical disinfection may be suitable for certain hard surfaces and PPE items such as goggles, but is not recommended for FFRs due to loss of filtration performance (e.g., alcohol [ 22 , 41 , 42 , 43 , 44 ]) or residual chemical odor (e.g., hypochlorite [ 77 ]).…”