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J Hosp Infect . Effectiveness of mouth rinses against COVID-19: A systematic review and network meta-analysis

tetano

Editor, Senior Moderator
J Hosp Infect


. 2023 Jul 5;S0195-6701(23)00208-6.
doi: 10.1016/j.jhin.2023.06.022. Online ahead of print. Effectiveness of mouth rinses against COVID-19: A systematic review and network meta-analysis

Shih-Ying Lin[SUP] 1 [/SUP], Jui-Sheng Sun[SUP] 2 [/SUP], Min-Chih Hung[SUP] 3 [/SUP], Jenny Zwei-Chieng Chang[SUP] 4 [/SUP]



Affiliations
Abstract

Objective: This systematic review and network meta-analysis (NMA) comprehensively compared the effectiveness of different mouth rinses in rex`ducing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load/infectivity (Part I), alleviating clinical symptoms or severity of disease (Part II), and decreasing the incidence of SARS-CoV-2 infection (Part III).
Methods: Randomized controlled trials (RCTs) or non-randomized controlled trials (NRCTs) with restrictions were searched up to 3 March 2023. Twenty-three studies (22 RCTs and 1 NRCT) met the inclusion criteria for systematic review.
Results: Five RCTs (454 patients and nine interventions) in Part I were eligible for NMA. Results of NMA showed that in comparison with no rinse, sodium chloride (NaCl) was most effective in reducing viral load, followed by povidone-iodine (PVP-I), ß-cyclodextrin+citrox (CDCM), hydrogen peroxide (HP), chlorhexidine gluconate (CHX), cetylpyridinium chloride (CPC), placebo, and HCIO (hypochlorous acid). However, these results were not statistically significant. Based on surface under the cumulative ranking curve scores, PVP-I was likely to be the most efficacious in reducing SARS-CoV-2 viral load, followed by CDCM, HP, NaCl, CHX, CPC, placebo, no rinse, and HCIO.
Conclusion: Due to heterogeneity of the primary studies, the effects of different mouth rinses to reduce viral infectivity, improve clinical symptoms, or to prevent SARS-CoV-2 infection remained inconclusive.

Keywords: Coronavirus disease in 2019; Mouth rinse; Mouth wash; Povidone-iodine; Saliva; severe acute respiratory syndrome coronavirus 2.

 
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