povidone-iodine and Pneumonia--Viral

Now COVID-19 is causing a severe public health emergency and the mortality is rapidly increasing all over the world. In the current pandemic era, although there have been many efforts to diagnose a number of patients with symptoms or close contacts, there is no definite guideline for the initial therapeutic approach for them and therefore, many patients have been dying due to a hyperinflammatory immunological reaction labeled as "cytokine storm". Severe patients are hospitalized and the treatment is done, though they have not been established yet. Currently, however, no treatment is provided for those who are isolated at home or shelter until they get severe symptoms, which will increase the harms to the patients. In this review, we discuss some important points dedicated to the management of patients with COVID-19, which should help reducing morbidity and mortality. In this era, we suggest 7 recommendations to rescue the patients and to reduce the morbidity and mortality due to COVID-19 based on the immunological point of view.

Topics: Anti-Bacterial Agents; Betacoronavirus; Coronavirus Infections; COVID-19; Cytokine Release Syndrome; Humans; Hydroxychloroquine; Lung; Morbidity; Mouthwashes; Nasal Sprays; Pandemics; Plant Preparations; Pneumonia, Viral; Povidone-Iodine; Sambucus; SARS-CoV-2; Smoking Cessation; Steroids

Approaches to nasal and oral decontamination with povidone-iodine (PVP-I) have been published to reduce nosocomial spread of Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV-2). The safety of PVP-I topically applied to the nasal and oral cavity is addressed by a literature review. The specific efficacy of PVP-I against coronaviruses and its potential efficacy against SARS-CoV-2 is discussed.. A review was performed utilizing PubMed and Cochrane Databases. All citations in protocols for nasal and oral PVP-I use regarding COVID-19 were independently reviewed.. Povidone-iodine has been safely administered for up to 5 months in the nasal cavity and 6 months in the oral cavity. Concentrations less than 2.5% in vitro do not reduce ciliary beat frequency or cause pathological changes in ciliated nasal epithelium, upper respiratory, or mucosal cells. Adverse events with oral use have not been reported in conscious adults or children. Allergy and contact sensitivity is rare. Chronic mucosal use up to 5% has not been shown to result in clinical thyroid disease. PVP-I is rapidly virucidal and inactivates coronaviruses, including SARS-CoV and Middle East Respiratory Syndrome (MERS).. Povidone-iodine can safely be used in the nose at concentrations up to 1.25% and in the mouth at concentrations up to 2.5% for up to 5 months. Povidone-iodine rapidly inactivates coronaviruses, including SARS and MERS, when applied for as little as 15 seconds. There is optimism that PVP-I can inactivate SARS-CoV-2, but in vitro efficacy has not yet been demonstrated.

Topics: Administration, Topical; Anti-Infective Agents, Local; Betacoronavirus; Coronavirus; Coronavirus Infections; COVID-19; Disinfection; Humans; Mouth; Nasal Cavity; Pandemics; Paranasal Sinuses; Pneumonia, Viral; Povidone-Iodine; SARS-CoV-2

An alarming fact was revealed by recent publications concerning disinfectants: chlorhexidine digluconate is ineffective for disinfecting surfaces contaminated by the new coronavirus. This is a finding that requires immediate disclosure since this substance is widely used for the disinfection of hands and forearms of surgeons and auxiliaries and in the antisepsis of patients in minimally invasive procedures commonly performed in hospital environments. The objective of this study is to compare the different disinfectants used for disinfection on several surfaces, in a review of worldwide works. Scientific studies were researched in the BVS (Virtual Health Library), PubMed, Medline, and ANVISA (National Health Surveillance Agency) databases. The following agents were studied: alcohol 62-71%, hydrogen peroxide 0.5%, sodium hypochlorite 0.1%, benzalkonium chloride 0.05-0.2%, povidone-iodine 10%, and chlorhexidine digluconate 0.02%, on metal, aluminum, wood, paper, glass, plastic, PVC, silicone, latex (gloves), disposable gowns, ceramic, and Teflon surfaces. Studies have shown that chlorhexidine digluconate is ineffective for inactivating some coronavirus subtypes, suggesting that it is also ineffective to the new coronavirus.

Topics: Anti-Infective Agents, Local; Chlorhexidine; Coronavirus; Coronavirus Infections; Disinfectants; Disinfection; Humans; Pandemics; Pneumonia, Viral; Povidone-Iodine

1- To compare the effectiveness of 1% Hydrogen peroxide, 0.2% Povidone-Iodine, 2% hypertonic saline and a novel solution Neem extract (Azardirachta indica) in reducing intra-oral viral load in COVID-19 positive patients. 2- To determine the salivary cytokine profiles of IL-2, IL-4, IL-6, IL-10, TNF-α, IFN-γ and IL- 17 among COVID-19 patients subjected to 1% Hydrogen peroxide, 0.2% Povidone-Iodine, 2% hypertonic saline or Neem extract (Azardirachta indica) based gargles.. This will be a parallel group, quadruple blind-randomised controlled pilot trial with an add on laboratory based study.. A non-probability, purposive sampling technique will be followed to identify participants for this study. The clinical trial will be carried out at the Aga Khan University Hospital (AKUH), Karachi, Pakistan. The viral PCR tests will be done at main AKUH clinical laboratories whereas the immunological tests (cytokine analysis) will be done at the Juma research laboratory of AKUH. The inclusion criteria are laboratory-confirmed COVID-19 positive patients, male or female, in the age range of 18-65 years, with mild to moderate disease, already admitted to the AKUH. Subjects with low Glasgow coma score, with a history of radiotherapy or chemotherapy, who are more than 7 days past the onset of COVID- 19 symptoms, or intubated or edentulous patients will be excluded. Patients who are being treated with any form of oral or parenteral antiviral therapy will be excluded, as well as patients with known pre-existing chronic mucosal lesions such as lichen planus.. Group A (n=10) patients on 10 ml gargle and nasal lavage using 0.2% Povidone-Iodine (Betadiene® by Aviro Health Inc./ Pyodine® by Brooks Pharma Inc.) for 20-30 seconds, thrice daily for 6 days. Group B (n=10) patients will be subjected to 10 ml gargle and nasal lavage using 1% Hydrogen peroxide (HP® by Karachi Chemicals Products Inc./ ActiveOxy® by Boumatic Inc.) for 20-30 seconds, thrice daily for 6 days. Group C will comprised of (n=10) subjects on 10ml gargle and nasal lavage using Neem extract solution (Azardirachta indica) formulated by Karachi University (chemistry department laboratories) for 20-30 seconds, thrice daily for 6 days. Group D (n=10) patients will use 2% hypertonic saline (Plabottle® by Otsuka Inc.) gargle and nasal lavage for a similar time period. Group E (n=10) will serve as positive controls. These will be given simple distilled water gargles and nasal lavage for 20-30 seconds, thrice daily for six days. For nasal lavage, a special douche syringe will be provided to each participant. Its use will be thoroughly explained by the data collection officer. After each use, the patient is asked not to eat, drink, or rinse their mouth for the next 30 minutes.. The primary outcome is the reduction in the intra-oral viral load confirmed with real time quantitative PCR.. The assignment to the study group/ allocation will be done using the sealed envelope method under the supervision of Clinical Trial Unit (CTU) of Aga Khan University, Karachi, Pakistan. The patients will be randomised to their respective study group (1:1:1:1:1 allocation ratio) immediately after the eligibility assessment and consent administration is done.. The study will be quadruple-blinded. Patients, intervention provider, outcome assessor and the data collection officer will be blinded. The groups will be labelled as A, B, C, D or E. The codes of the intervention will be kept in lock & key at the CTU and will only be revealed at the end of study or if the study is terminated prematurely.. As there is no prior work on this research question, so no assumptions for the sample size calculation could be made. The present study will serve as a pilot trial. We intend to study 50 patients in five study groups with 10 patients in each study group. For details, please refer to Fig. 1 for details.. Protocol version is 7.0, approved by the department and institutional ethics committees and clinical trial unit of the university hospital. Recruitment is planned to start as soon as the funding is sanctioned. The total duration of the study is expected to be 6 months i.e. August 2020-January 2021.. This study protocol was registered at www.clinicaltrials.gov on 10 April 2020 NCT04341688 .. The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol. The study protocol has been reported in accordance with the Standard Protocol Items: Recommendations for Clinical Interventional Trials (SPIRIT) guidelines (Additional file 2). Fig. 1 Flow diagram of study-participants' timeline.

Topics: Adult; Anti-Infective Agents, Local; Azadirachta; Betacoronavirus; Coronavirus Infections; COVID-19; Female; Hospitalization; Humans; Hydrogen Peroxide; Male; Monitoring, Immunologic; Mouthwashes; Nasal Lavage; Pandemics; Plant Extracts; Pneumonia, Viral; Povidone-Iodine; Randomized Controlled Trials as Topic; Saline Solution, Hypertonic; SARS-CoV-2; Viral Load

Topics: Anti-Infective Agents, Local; Betacoronavirus; Coronavirus Infections; COVID-19; Cross Infection; Head and Neck Neoplasms; Humans; Medical Oncology; Pandemics; Personal Protective Equipment; Pneumonia, Viral; Povidone-Iodine; Public Health; SARS-CoV-2; Skull Base

The COVID-19 pandemic has resulted in society experiencing unprecedented challenges for health care practitioners and facilities serving at the frontlines of this pandemic. With regard to oral cancer, there is a complete absence of literature regarding the long-term impact of pandemics on patients with oral potentially malignant disorders (OPMDs). The objective of this article is to put forth an institutional multidisciplinary approach for the evaluation and management of OPMDs.. A multidisciplinary approach was put formalized within our institution to risk stratify patients based on need for in-person assessment vs telehealth assessment during the COVID-19 pandemic.. With judicious risk stratification of patients based on clinical features of their OPMD and with consideration of ongoing mitigation efforts and regional pandemic impact, providers are able to safely care for their patients.. The COVID-19 pandemic has required health care practitioners to make novel decisions that are new to us with development of creative pathways of care that focused on patient safety, mitigation efforts, and clinical management of disease processes. The care of patients with OPMDs requires special considerations especially as patients at high risk for severe COVID-19 illness are also higher risk for the development of OPMDs.

Topics: Administration, Topical; Anti-Infective Agents, Local; Betacoronavirus; Clinical Decision-Making; Coronavirus Infections; COVID-19; Critical Pathways; Diagnosis, Differential; Humans; Infection Control; Infectious Disease Transmission, Patient-to-Professional; Leukoplakia, Oral; Mouth Neoplasms; Pandemics; Personal Protective Equipment; Pneumonia, Viral; Povidone-Iodine; Risk Assessment; SARS-CoV-2; Telemedicine

Topics: Administration, Ophthalmic; Anti-Infective Agents, Local; Betacoronavirus; Coronavirus Infections; COVID-19; Disease Transmission, Infectious; Eye Infections, Viral; Humans; Ophthalmic Solutions; Pandemics; Pneumonia, Viral; Povidone-Iodine; SARS-CoV-2

Topics: Anti-Infective Agents, Local; Benzalkonium Compounds; Betacoronavirus; Coronavirus Infections; COVID-19; Cross Infection; Disease Transmission, Infectious; Eye Infections, Viral; Hand Disinfection; Humans; Infection Control; Masks; Pandemics; Pneumonia, Viral; Povidone-Iodine; SARS-CoV-2

To investigate the optimal contact time and concentration for viricidal activity of oral preparation of povidone-iodine (PVP-I) against SARS-CoV-2 ('corona virus') to mitigate the risk and transmission of the virus in the dental practice.. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) USA-WA1/2020 strain, virus stock was tested against oral antiseptic solutions consisting of aqueous povidone-iodine (PVP-I) as the sole active ingredient. The PVP-I was tested at diluted concentrations of 0.5%, 1%, and 1.5%. Test media without any virus was added to 2 tubes of the compounds to serve as toxicity and neutralization controls. Ethanol (70%) was tested in parallel as a positive control, and water only as a negative control. The test solutions and virus were incubated at room temperature (22 ± 2 °C) for time periods of 15 and 30 seconds. The solution was then neutralized by a 1/10 dilution in minimum essential medium (MEM) 2% fetal bovine serum (FBS), 50 µg/mL gentamicin. Surviving virus from each sample was quantified by standard end-point dilution assay and the log reduction value (LRV) of each compound compared to the negative (water) control was calculated.. PVP-I oral antiseptics at all tested concentrations of 0.5%, 1%, and 1.5%, completely inactivated SARS-CoV-2 within 15 seconds of contact. The 70% ethanol control group was unable to completely inactivate SARS-CoV-2 after 15 seconds of contact, but was able to inactivate the virus at 30 seconds of contact.. PVP-I oral antiseptic preparations rapidly inactivated SARS-CoV-2 virus in vitro. The viricidal activity was present at the lowest concentration of 0.5 % PVP-I and at the lowest contact time of 15 seconds. This important finding can justify the use of preprocedural oral rinsing with PVP-I (for patients and health care providers) may be useful as an adjunct to personal protective equipment, for dental and surgical specialties during the COVID-19 pandemic.

Topics: Anti-Infective Agents, Local; Betacoronavirus; Coronavirus Infections; COVID-19; Humans; Pandemics; Pneumonia, Viral; Povidone-Iodine; SARS-CoV-2

The coronavirus disease 2019 (COVID-19) pandemic has become a major public health crisis. The diagnostic and containment efforts for the disease have presented significant challenges for the global health-care community. In this brief report, we provide perspective on the potential use of salivary specimens for detection and serial monitoring of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), based on current literature. Oral health-care providers are at an elevated risk of exposure to COVID-19 due to their proximity to nasopharynx of patients, and the practice involving the use of aerosol-generating equipment. Here, we summarize the general guidelines for oral health-care specialists for prevention of nosocomial transmission of COVID-19, and provide specific recommendations for clinical care management.

Topics: Anti-Infective Agents, Local; Betacoronavirus; Coronavirus Infections; COVID-19; Dentists; Guidelines as Topic; Humans; Infection Control; Infectious Disease Transmission, Patient-to-Professional; Mouthwashes; Occupational Exposure; Pandemics; Personal Protective Equipment; Pneumonia, Viral; Povidone-Iodine; Practice Patterns, Dentists'; Respiratory Protective Devices; Saliva; SARS-CoV-2; United States

Topics: Betacoronavirus; Coronavirus Infections; COVID-19; Humans; Infection Control; Pandemics; Pneumonia, Viral; Povidone-Iodine; Prosthodontics; SARS-CoV-2; Virus Inactivation

To evaluate the in vitro inactivation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with hydrogen peroxide (H. 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 H. 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 H. 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.

Topics: Anti-Infective Agents, Local; Betacoronavirus; Coronavirus Infections; COVID-19; Humans; Hydrogen Peroxide; Pandemics; Pneumonia, Viral; Povidone-Iodine; SARS-CoV-2; Severe acute respiratory syndrome-related coronavirus

Topics: Betacoronavirus; Coronavirus Infections; COVID-19; Humans; Pandemics; Pneumonia, Viral; Povidone; Povidone-Iodine; SARS-CoV-2; Severe acute respiratory syndrome-related coronavirus

Topics: Betacoronavirus; Coronavirus Infections; COVID-19; Humans; Pandemics; Pneumonia, Viral; Povidone; Povidone-Iodine; SARS-CoV-2

Topics: Administration, Oral; Aerosols; Anti-Infective Agents, Local; Betacoronavirus; Conflict of Interest; Coronavirus Infections; COVID-19; Humans; Mouthwashes; Oropharynx; Pandemics; Pneumonia, Viral; Povidone-Iodine; Research Design; SARS-CoV-2; Viral Load

Topics: Betacoronavirus; Carrageenan; Coronavirus Infections; COVID-19; Humans; Infection Control; Pandemics; Pneumonia, Viral; Povidone-Iodine; Public Health; SARS-CoV-2; Severe acute respiratory syndrome-related coronavirus; Skull Base

The COVID-19 pandemic has raised concerns of inadvertent SARS-CoV-2 transmission to healthcare workers during routine procedures of the aerodigestive tract in asymptomatic COVID-19 patients. Current efforts to mitigate this risk focus on Personal Protective Equipment, including high-efficiency filtration as well as other measures. Because the reservoir for SARS-CoV-2 shedding is in the nasopharynx and nasal and oral cavities, the application of viricidal agents to these surfaces may reduce virus burden. Numerous studies have confirmed that povidone-iodine inactivates many common respiratory viruses, including SARS-CoV-1. Povidone-iodine also has good profile for mucosal tolerance. Thus, we propose a prophylactic treatment protocol for the application of topical povidone-iodine to the upper aerodigestive tract.. Such an approach represents a low-cost, low-morbidity measure that may reduce the risks associated with aerosol-generating procedures performed commonly in otorhinolaryngology operating rooms.

Topics: Adult; Aerosols; Anti-Infective Agents, Local; Betacoronavirus; Coronavirus Infections; COVID-19; Disease Transmission, Infectious; Humans; Mouth; Pandemics; Pneumonia, Viral; Povidone-Iodine; SARS-CoV-2