Introduction
throat, infection, respiratory
syndrome coronavirus 2, coronavirus disease 2019
VIRUS, CORONAVIRUS DISEASE 2019, INFECTION, CORONAVIRUS, SEVERE ACUTE RESPIRATORY SYNDROME
Authors contributing equally to this article.Soon after the outbreak of the coronavirus disease 2019 (COVID-19) pandemic,
preprocedural mouthwashes were recommended for temporarily reducing intraoral viral load
and infectivity of individuals potentially infected with the severe acute respiratory
syndrome coronavirus 2 (SARS-CoV-2) in order to protect medical personnel. Particularly,
the antiseptic cetylpyridinium chloride (CPC) has shown virucidal effects against
SARS-CoV-2 in vitro. Therefore, the aim of this randomized controlled clinical trial was
to investigate the efficacy of a commercially available mouthwash containing CPC and
chlorhexidine digluconate (CHX) at 0.05% each in SARS-CoV-2–positive patients as compared
to a placebo mouthwash. Sixty-one patients who tested positive for SARS-CoV-2 with onset
of symptoms within the last 72 h were included in this study. Oropharyngeal specimens were
taken at baseline, whereupon patients had to gargle mouth and throat with 20 mL test or
placebo (0.9% NaCl) mouthwash for 60 s. After 30 min, further oropharyngeal specimens were
collected. Viral load was analyzed by quantitative reverse transcriptase polymerase chain
reaction, and infectivity of oropharyngeal specimens was analyzed by virus rescue in cell
culture and quantified via determination of tissue culture infectious doses 50%
(TCIDCoronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2), an enveloped single-stranded RNA virus, which is primarily
transmitted by direct contact or airborne transmission via droplets and aerosols (Therefore, right after onset of the COVID-19 pandemic, it was discussed that health care
professionals (HCPs) from disciplines with close patient contact, where no face masks can be
worn by the patients during examination and therapy, could be at high risk for nosocomial
infection with SARS-CoV-2, including dentists, maxillofacial surgeons, and
otorhinolaryngologists (Chlorhexidine digluconate (CHX) and cetylpyridinium chloride (CPC) can be considered the
antiseptics that are most commonly used in dental practice (Therefore, the aim of the present study was to investigate the efficacy of a commercially
available mouthwash containing CHX and CPC regarding the reduction of the intraoral viral
load and infectivity in SARS-CoV-2–positive patients as compared to a placebo mouthwash by
using qRT-PCR for detection of viral load and virus rescue in cell culture for evaluation of
viral infectivity. In addition, viral load and infectivity were also assessed with respect
to the COVID-19 vaccination status of the patients.