Effective <i>in-vitro</i> inactivation of SARS-CoV-2 by commercially available mouthwashes

Davies, Katherine; Buczkowski, Hubert; Welch, Stephen R.; Green, Nicole; Mawer, Damian; Woodford, Neil; Roberts, Allen D. G.; Nixon, Peter J.; Seymour, David; Killip, Marian J.

doi:10.1101/2020.12.02.408047

Cited by 10 publications

(17 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In contrast, within the same experiment, a mouthwash containing CHX (0.2% chlorhexidine gluconate), exhibited poorer virucidal activity against SARS-CoV-2. Our observationsare consistent with others, where a number of different CPC mouthwashformulations have been shown to effectively inactivate SARS-CoV-2 in vitro , whereas CHX containing mouthwashes are reported to have modest ability to inactive SARS-CoV-2 [6, 19, 21]. The virucidal action of CPC mouthwash was maintainedin the presence of whole human saliva, consistent with human clinical trials which report that rinsing with CPC mouthwash can lower SARS-CoV-2 salivary count for several hours after use [7, 28].…”

Section: Discussionsupporting

confidence: 92%

Virucidal activity of CPC-containing oral rinses against SARS-CoV-2 variants and are active in the presence of human saliva

Anderson

Patterson

Richards

et al. 2021

Preprint

View full text Add to dashboard Cite

The role of human saliva in aerosol-based transmission of SARS-CoV-2 has highlighted the need to understand the potential of oral hygiene products to inactivate the virus. Here we examined the efficacy of mouthwashes containing cetylpyridinium chloride (CPC) or chlorhexidine (CHX) in inactivating SARS-CoV-2. After 30 seconds contact under standard aqueous conditions CPC mouthwashes achieved a ≥4.0log10 PFU/mLreduction in SARS-CoV-2 (USA-WA1/2020) titres whereas comparable products containing CHX achieved <2.0log10 PFU/mL reduction. Further testing with CPC mouthwashes demonstrated efficacy against multiple SARS-CoV-2 variants, with inactivation below the limit of detection observed against the Alpha (B.1.1.7), Beta (B.1.35.1) and Gamma (P.1) variants. Virucidal efficacy of CPC mouthwash was also observed in the presence of human saliva with the product delivering ≥4.0log10 PFU/mL reduction in SARS-CoV-2 titres after 30 seconds providing additional evidence for the virucidal efficacy of CPC mouthwashes under simulated physiological conditions. Together these data suggest CPC-based mouthwashes are effective at inactivating SARS-CoV-2 and further supports the use of mouthwash to mitigate the risk of transmission during dentistry procedures.

show abstract

Section: Discussionsupporting

confidence: 92%

Virucidal activity of CPC-containing oral rinses against SARS-CoV-2 variants and are active in the presence of human saliva

Anderson

Patterson

Richards

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…All in vitro studies presented an unclear risk of bias for randomization, allocation concealment, and blinding of the evaluators (Fig. 2 ) [ 23 – 38 , 40 , 44 – 47 ]. Based on RoB 2 assessment, overall low risk of bias was detected in two studies [ 41 , 42 ].…”

Section: Resultsmentioning

confidence: 99%

Virucidal efficacy of chlorhexidine: a systematic review

et al. 2021

View full text Add to dashboard Cite

This study aimed to systematically review the literature about the virucidal efficacy of CHX in comparison to other substances used in the oral cavity. Electronic searches were performed in four databases (PubMed, Scopus, Embase, and Web of Science). Only studies that presented the following characteristics were included: (1) verified virucidal efficacy of CHX against Herpes Simplex Type-1 (HSV-1), any Influenza, or any human coronavirus (HcoV); and (2) compared the virucidal efficacy of CHX with essential oils (Listerine ® ), quaternary ammonium compounds, povidone-iodine, hydrogen peroxide, negative control substance, and absence of therapy. Two researchers independently selected the studies, extracted data and evaluated the risk of bias. A narrative data synthesis was used. Twenty-five studies were included, of which 21 were in vitro and four were randomized clinical trials (RCT). Studies assessed the virucidal efficacy of CHX against Herpes Simplex Type-1 (HSV-1) (10 studies), Influenza A (InfluA) (4 studies), human coronavirus (HCoV) (4 studies) and Severe Acute Respiratory Syndrome-Related Coronavirus (SARS-CoV-2) (11 studies). Most studies demonstrated that CHX has a positive virucidal efficacy against HSV-1 and InfluA strains. However, lower efficacy was shown to InfluA strain in comparison to povidone-iodine. Lower to none virucidal efficacy of CHX is expected for HCoV and SARS-CoV-2 strains for in vitro studies. Three RCT demonstrated that CHX was able to significantly reduce the viral load of SARS-CoV-2 for a short period. CHX may present an interesting virucidal efficacy against HSV-1 and InfluA viruses. CHX also presents transient efficacy against SARS-CoV-2 when used as a mouthwash.

show abstract

“…Through our in vitro studies, we demonstrated the virucidal activity of a variety of PVP-I formulations, such as gargle/oral rinse, solution, and scrub, at different concentrations and with complementary uses in medical, dental, or surgical settings and personal care settings, when challenge tested against alphacoronavirus and betacoronavirus strains that served as surrogates for SARS-CoV-2. It is encouraging to see recent preclinical and clinical evidence demonstrating PVP-I-mediated in vitro inactivation of SARS-CoV-2 [ 40 – 45 ] as well as reduction in viral load using PVP-I oral formulations in randomized clinical trials on patients with COVID-19 [ 46 , 47 ]. Our findings and studies by other groups, together, strengthen the evidence for implementing the use of various PVP-I formulations in medical and personal care settings against a family of coronavirus strains, including SARS-CoV-2, as a broad-spectrum virucidal agent that neutralizes human and murine coronaviruses, potentially informing behaviors and preventing transmission during future pandemics.…”

Section: Discussionmentioning

confidence: 99%

In Vitro Evaluation of the Virucidal Activity of Different Povidone–Iodine Formulations Against Murine and Human Coronaviruses

Shet¹,

Hong²,

Igo³

et al. 2021

Infect Dis Ther

View full text Add to dashboard Cite

Introduction Polyvinylpyrrolidone–iodine (PVP-I) demonstrates broad-spectrum anti-infective activity and is available in different formulations for oral rinse and topical use in medical and personal care settings. The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has underscored the need to supplement available preventive strategies. Methods We assessed virucidal activity of PVP-I formulations, including 0.5% (w/v) solution, 5.0% (w/v) solution, 7.5% (w/v) scrub, and 10.0% (w/v) solution, versus placebos when challenged with coronaviruses in two in vitro studies. Murine coronavirus strain A59 (American Type Culture Collection [ATCC] ® VR-764™), human coronavirus strain OC43 (ZeptoMetrix Corp. #0810024CF), human coronavirus strain NL63 (ZeptoMetrix Corp. #0810228CF), and human coronavirus strain 229E (ATCC ® VR-740™) were used as surrogates for SARS-CoV-2. Both studies used the American Society for Testing and Materials in vitro time-kill method. Results All active PVP-I formulations in study 1 demonstrated virucidal activity at 15 s, with mean log 10 reduction of greater than 4.56 or greater than 99.99% inactivation; a cytotoxic effect against the National Collection of Type Cultures clone 1469 host cells was observed with 5.0% (w/v) solution, 7.5% (w/v) scrub, and 10.0% (w/v) solution. Active PVP-I formulations in study 2 demonstrated effective virucidal activity against coronaviruses in less than 15 s; log 10 reduction in viral titer for each coronavirus strain was consistently higher for 10.0% (w/v) solution and 0.5% (w/v) solution versus 7.5% (w/v) scrub. Conclusion Both studies demonstrated in vitro virucidal activity of PVP-I formulations when challenged with SARS-CoV-2 surrogate coronaviruses . Although promising, further investigations are needed to evaluate SARS-CoV-2 inactivation.

show abstract

Effective in-vitro inactivation of SARS-CoV-2 by commercially available mouthwashes

Cited by 10 publications

References 16 publications

Virucidal activity of CPC-containing oral rinses against SARS-CoV-2 variants and are active in the presence of human saliva

Virucidal activity of CPC-containing oral rinses against SARS-CoV-2 variants and are active in the presence of human saliva

Virucidal efficacy of chlorhexidine: a systematic review

In Vitro Evaluation of the Virucidal Activity of Different Povidone–Iodine Formulations Against Murine and Human Coronaviruses

Contact Info

Product

Resources

About