Decontaminating the Nose, Mouth and Throat of SARS-CoV-2 with Povidone-Iodine – Aren’t We Missing Out on Very Effective Prevention and Prophylactic Tools in the War Against the COVID-19 Pandemic?

Abstract

Background: An outbreak of a new coronavirus, the SARS-CoV-2 (or COVID-19) has resulted in more than two million infected people and tens of thousands of deaths (the situation quickly evolves on daily basis). Fortunately, majority of patients experience only mild upper respiratory tract symptoms, or no symptoms at all, loss of smell and taste being the predominant complaint.

But, unfortunately, even asymptomatic individuals can unknowingly spread the infection, which makes the pandemic very difficult to get under control. While lockdowns for entire country populations have shut down economies and international trade, the WHO has warned they may not be enough despite their high long-term economic and social costs.

However, little or no scientific information has circulated reviewing already existing effective science- and evidence-based preventive/prophylactic measures that "kill" SARS-CoV-1 and are likely also to inactivate the current SARS- CoV-2.

Our personal communication aims to fill this void.

Method: First, we review the scientific literature and the evidence on preventive/prophylactic measures that neutralize SARS-CoV-1 virus. Second, our analysis looks into the scientific evidence on the use of povidone-iodine (PVP-I) in mouthwash/gargling/spray forms, as these represent the only innovatively developed, tested and available practical solution to inactivate SARS-CoV viruses (e.g. SARS-CoV-1, Middle-East Respiratory Syndrome virus or MERS, and SARS-CoV-2).

Findings: Multiple evidence (mainly in vitro/cell cultures) demonstrate that the use of povidone-iodine (PVP-I) inactivates SARS-CoV-1 in matter of seconds. Preliminary test results suggest it may also similarly “kill” the current new SARS-CoV-2.

Update [1 January 2021]: new evidence confirms that PVP-I inactivates SARS-CoV-2.

Discussion: The use of PVP-I for decontamination of the nose/mouth/throat has a well-established tolerability profile, is low-cost and has limited downside risks. It is an evidence-based and highly cost-effective health intervention. Our analysis suggests that PVP-I utilization merits being considered as an additional preventive measure (in clinical and in population settings) against getting infected by, and infecting others with, the current SARS-CoV-2 virus. However, the real-world evidence (in vivo) of their effectiveness in the form of mouthwashes/gargles/sprays for the decontamination of the nose, mouth and throat, is rather scarce.

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Note: This article is a personal communication engaging nobody else than the authors. Our intention is to inform the scientific debate. Any remaining errors remain ours.

Funding: no funding

Declaration of Interest: None.

Keywords: SARS-CoV-1, SARS-CoVid-1, SARS-CoV-2, SARS-CoVid-2, COVID-19, COVID19, pandemic, povidone-iodine, povidone iodine, PVP-I, prevention, prophylactic health interventions

JEL Classification: F60, F62, F69, H12, H19, H51, I18, I19, I38, I39, O32, Z18