Randomised controlled trial of rhinothermy for treatment of the common cold: a feasibility study

Hei, Susanne J. van de; McKinstry, Steven; Bardsley, George; Weatherall, Mark; Beasley, Richard; Fingleton, James

doi:10.1136/bmjopen-2017-019350

Cited by 5 publications

(9 citation statements)

References 42 publications

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“…56 To the extent that temperature is implicated in a smoker's physiology, it is reasonable to consider that there are a host of much more benign ways to warm the respiratory tract than smoking. Though the evidence was deemed inconclusive in a Cochrane review, 57 several controlled trials [58][59][60] were cited of various heat treatments (e.g. steam) showing successful reduction of symptoms or duration of colds, another illness sometimes caused by a coronavirus.…”

Section: Discussionmentioning

confidence: 99%

National Smoking Rates Correlate Inversely with COVID-19 Mortality

Norden¹,

Avery

Norden

et al. 2020

Preprint

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IntroductionRecent studies show cigarette smokers are markedly under-represented among patients hospitalized for COVID-19 in over a dozen countries. It is unclear if this may be related to confounding factors such as age distribution, access to care, and inaccurate records. We hypothesized that these concerns could be avoided by studying smoking prevalence in relation to COVID-19 mortality. Since climate has been identified as a factor in COVID-19, we studied groups of countries with relatively comparable temperatures.MethodsThe 20 hottest and 20 coldest countries in the Johns Hopkins Mortality Analysis database with a minimum mortality rate of .3 deaths/100,000 were selected on the basis of the average temperatures of their largest city. Mortality rates were determined as of May 1, 2020 and correlated with national smoking rate adjusting for sex ratio, obesity, temperature, and elderly population.ResultsA highly significant inverse correlation between current daily smoking prevalence and COVID-19 mortality rate was noted for the group of hot countries (R=-.718, p = .0002), cold countries (R=-.567, p=.0046), and the combined group (R=-.324, p=.0207). However, after adjustments only the regression for hot countries and the combined group remained significant. In hot countries, for each percentage point increase in smoking rate mortality decreased by .147 per 100,000 population (95% CI .102-192, p=.0066). This resulted in mortality rates several-fold elevated in the countries with the lowest smoking rates relative to the highest smoking rates. In the combined group, mortality decreased by .257 per 100,000 population (95% CI .175-.339, p=.0034).DiscussionThese findings add support to the finding of an inverse relationship between current smoking and seriously symptomatic COVID-19. However, we conclude that the difference in mortality between the highest and lowest smoking countries appears too large to be due primarily to the effects of smoking per se. A potentially beneficial effect of smoking is surprising, but compatible with a number of hypothetical mechanisms which deserve exploration: 1) Studies show smoking alters ACE2 expression which may affect COVID-19 infection or its progression to serious lung pathology. 2) Nicotine has anti-inflammatory activity and also appears to alter ACE2 expression. 3) Nitric oxide in cigarette smoke is known to be effective in treating pulmonary hypertension and has shown in vitro antiviral effects including against SARS-CoV-2. 4) Smoking has complicated effects on the immune system involving both up and down regulation, any of which might alone or in concert antagonize progression of COVID-19. 5) Smokers are exposed to hot vapors which may stimulate immunity in the respiratory tract by various heat-related mechanisms (e.g. heat shock proteins). Studies of steam and sauna treatments have shown efficacy in other viral respiratory conditions. At this time there is no clear evidence that smoking is protective against COVID-19, so the established recommendations to avoid smoking should be emphasized. The interaction of smoking and COVID-19 will only be reliably determined by carefully designed prospective study, and there is reason to believe that there are unknown confounds that may be spuriously suggesting a protective effect of smoking. However, the magnitude of the apparent inverse association of COVID-19 and smoking and its myriad clinical implications suggest the importance of further investigation.

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Section: Discussionmentioning

confidence: 99%

National Smoking Rates Correlate Inversely with COVID-19 Mortality

Norden¹,

Avery

Norden

et al. 2020

Preprint

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“…The WHO laboratory work shows that heat at 56ºC kills the SARS coronavirus at around 10,000 units per 15 min. This could pave way for a potential therapeutic prospect of warm steam inhalation/heated humidified air delivery/rhinothermy, which has been traditionally and clinically proven to be potent against viral upper respiratory tract infections [17][18][19].…”

Section: Therapeutic Prospectsmentioning

confidence: 99%

SARS-CoV-2: Current Perspective on Control, Prevention, and Therapeutic Promise

Ikwuka¹,

Nwobodo

Anayehie

et al. 2020

Sudan JMS

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Background: The novel coronavirus disease (COVID-19) outbreak has halted activities throughout the globe because of its rapid spread. COVID-19 is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) a β-coronavirus first detected in China. SARS-CoV-2 has been implicated to be transmitted via direct contact, fomite, respiratory droplets, and possibly aerosol. The spread of the disease is complicated due to the slow onset of symptoms and asymptomatic infected patients. Methods: This narrative communication summarizes the recent researches sourced using sensitive search strategies to identify COVID-19 current perspectives on the control, prevention, and therapeutic promise. Result: Several strategies and multiple control measures have been implemented around the globe to contain COVID-19. Considering the exponential spread of the pandemic, several scientists and physicians have been racing to discover possible therapeutics and vaccines for COVID-19. There are clinical trials to investigate the vaccine designed to protect against the infection and also to substantiate the claim made for BCG protection against COVID-19. Although, there is currently no universally approved medication to treat SARS-CoV-2, there have been random reports of existing medications ameliorating the infection, and these regimens are still under clinical trial. There is also the potential therapeutic prospect of rhinothermy to fight SARS-CoV-2 judging from its success in fighting upper respiratory tract viral infection. Conclusion: The information provided in this communication gives a reliable intellectual grounding regarding the current perspective on COVID-19 control, progress made in the development of vaccines and therapeutic regimen, and where future research in this area should be focused. Key words: COVID-19; SARS-CoV-2; control; WHO; respiratory; cases; tract

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“…Curcumin, active component of turmeric is responsible for its anti-inflammatory effect, antiseptic and antibacterial properties and black pepper acts as a bioenhancer. (12, 13)…”

Section: Discussionmentioning

confidence: 99%

“…Eight symptoms namely sneezing, nasal discharge, nasal congestion, sore throat, cough, headache, malaise, and fever were scored from 0 to 3 (0 for no symptoms, 1 for mild, 2 moderate and 3 for severe symptoms). (12) Patients were asked to rate their symptoms based on the severity. Quality of life was assessed using WHO QOL BREF questionnaire.…”

Section: Methodsmentioning

confidence: 99%

AYUSH medicine as add-on therapy for mild category COVID-19; an open label randomised, controlled clinical trial

Rao

Ramanjaneya

Gunaseelan

et al. 2020

Preprint

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BackgroundAYUSH formulations have a potential role in symptomatic treatment, preventing disease progression and improving quality of life in COVID-19 patients.ObjectiveTo study the effect of AYUSH formulation (Kabasura Kudineer tablets, Shakti drops and Turmeric plus) as an add-on treatment in patients with mild COVID - 19MethodologySingle centre, two arms, open labelled randomized controlled trial with a total of 30 patients (15 in the intervention arm and 15 in the standard care arm). Intervention arm received a combination of 3 AYUSH formulation along with the standard of care treatment for 21 days. All patients were followed for 28 days. Symptom severity (using Modified Jackson scale), negative conversion of SARS-CoV-2 RNA (using RTPCR) and quality of life (WHOWOL BREF questionnaire) was assessed.ResultsFifteen patients (93.8%) in the intervention group and twelve patients (92.3%) in the standard care arm had complete resolution of symptoms (P value= 0.36). Negative conversion for SARS-CoV-2 was seen in thirteen patients (92.9%) in intervention arm and eleven patients (100%) in standard care arm at day 28 (P value = 0.56). There was no difference in the quality of life scores between the 2 groups.ConclusionThe use of Ayush interventions as add-on therapy did not negatively impact the clinical outcomes in COVID-19. This trial confirmed the safety and tolerability of Kabasura Kudineer tablets, Shakti drops and Turmeric plus tablets when used use among mild to moderate symptom category, of COVID-19. There were no serious adverse events in the treated group. There was no clinical progression of disease from baseline status and all trial participants recovered fully by day 28. A longer follow up and a larger sample size is recommended for future definitive trials with this alternative medicine (AYUSH) combination.

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Randomised controlled trial of rhinothermy for treatment of the common cold: a feasibility study

Cited by 5 publications

References 42 publications

National Smoking Rates Correlate Inversely with COVID-19 Mortality

National Smoking Rates Correlate Inversely with COVID-19 Mortality

SARS-CoV-2: Current Perspective on Control, Prevention, and Therapeutic Promise

AYUSH medicine as add-on therapy for mild category COVID-19; an open label randomised, controlled clinical trial

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