Safety and Impact of Nasal Lavages During Viral Infections Such as SARS-CoV-2

Abstract

Much has been stated about the potential risks of nasal lavages (NL) during the coronavirus disease 2019 (COVID-19) pandemic for COVID-19 patients and surrounding people. Several otolaryngological societies recommended to limit NL, supposing it may be associated with viral spread to lower airway. 1 On the contrary, recent studies suggested that NL may be beneficial in upper viral respiratory infectious diseases. In order to take stock of this issue, we conducted a short literature review to address 4 main questions: 1 COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Otorhinolaryngological Societies (YO

Rapid initiation of nasal saline irrigation to reduce severity in high-risk COVID+ outpatients: a randomized clinical trial compared to a national dataset observational arm

“…Multiple studies have demonstrated immediate viral load reductions in vitro and in vivo with direct oral or nasal application of antivirals, [8][9][10] or the theoretical benefit of lavaging and gargling. [36][37][38] One study of povidone-iodine gargles and sprays in 24 patients did not show a significant reduction in viral load, but the age difference of 23 years between control and intervention groups calls randomization into question . 39 An interim analysis of a twice daily nasal irrigation trial in 45 young adults showed initial clinical improvement, 17 but was ultimately underpowered.…”

“…Multiple studies have demonstrated immediate viral load reductions in vitro and in vivo with direct oral or nasal application of antivirals,(7-9) or the theoretical benefit of lavaging and gargling. (36)(37)(38) However, a small study of gargles and sprays of effective povidone-iodine did not show a significant reduction in viral load,(39) nor were clinical differences seen in a small randomized trial using twice daily nasal irrigation without an effective virucidal. (17) Multiple commentaries have supported the concept and safety(37) of debridement.…”

Coating with Hypertonic Saline Improves Virus Protection of Filtering Facepiece Manyfold—Benefit of Salt Impregnation in Times of Pandemic

“…A recently published review focused on the vulnerability of SARS-CoV-2 regarding NaCl and presented this in detail [ 8 ]. This type of antiviral activity, utilized against a wide range of viral infections, can be augmented by the availability of NaCl [ 9 , 10 ]. Virus particles are sensitive to dehydrating conditions (as exerted by salt) because they need structurally unmodified surface proteins and nucleic acids for the binding and infection of target cells.…”

Machine learning and network medicine approaches for drug repositioning for COVID-19

“…Our analysis reveals that many of these drugs are linked to ongoing efforts against COVID-19: several top-ranked BSAs from our matrix decomposition model are part of ongoing clinical trials for COVID-19, or are even already approved for compassionate use in COVID-19 patients [56][57][58][59] ; several top-ranked drugs from our network medicine approach have also shown efficacy either as therapeutic alternatives or as instruments for reducing risk of infection and transmission. [60][61][62][63] An in-depth analysis of the top 20 predictions, including an analysis of their ATC classification and references to the literature, is presented in Note S11. A comparison with the set of drugs predicted by Gordon et al 14 is also provided in Note S9.…”