A Comparison of the Effects of Chlorhexidine and Sodium Bicarbonate Mouthwashes on COVID 19–Related Symptoms
Abstract
Background: Some studies have reported that mouthwashes can decrease the viral load in the mouth, but there is not much information about the effectiveness of mouthwashes on coronavirus disease 2019 (COVID‑19). This study was conducted to compare the impact of using two types of mouthwash, chlorhexidine and sodium bicarbonate, on COVID‑19 symptoms and infection.
Materials and Methods: The present three‑group, double‑blind clinical trial examined 116 operating room nurses and anesthesia personnel of certain hospitals of Isfahan University of Medical Sciences, Isfahan, Iran. The participants were randomly assigned to three groups: intervention group 1 (chlorhexidine mouthwash), intervention group 2 (sodium bicarbonate mouthwash), and the control group (placebo). Mouthwash was used twice a day (morning and night) for 2 weeks. The participants were monitored in terms of COVID‑19–related symptoms for 4 weeks, from the first day of mouthwash use.
Results: Fisher’s exact test indicated a significant difference between the chlorhexidine and control groups in terms of the onset of COVID‑19–related symptoms (p = 0.02). There was no significant difference in the symptoms of COVID‑19 between the groups, but the groups were significantly different in terms of all symptoms at a 4‑week interval (p = 0.04). Furthermore, headache was less observed in the chlorhexidine (p = 0.007) and sodium bicarbonate (p = 0.03) groups compared to the control group.
Conclusions: The use of 0.2% chlorhexidine mouthwash can decrease the onset of COVID‑19–related symptoms in health‑care workers. In addition, this mouthwash can partially reduce the symptoms of this disease in comparison to the control and sodium bicarbonate groups.
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Yuki K, Fujiogi M, Koutsogiannaki S. COVID-19 pathophysiology: A review. Clin Immunol 2020;215:108427.
Meng L, Hua F, Bian Z. Coronavirus disease 2019 (COVID-19): Emerging and future challenges for dental and oral medicine. J Dent Res 2020;99:481-7.
Yang L, Liu S, Liu J, Zhang Z, Wan X, Huang B, et al. COVID-19: Immunopathogenesis and Immunotherapeutics. Signal Transduct Target Ther 2020;5:1-8.
Ali I, Alharbi OM. COVID-19: Disease, management, treatment, and social impact. Sci Total Environ 2020;728:138861.
Walls AC, Park YJ, Tortorici MA, Wall A, McGuire AT, Veesler D. Structure, function, and antigenicity of the SARS-CoV-2 spike glycoprotein. Cell J 2020;181:281-92.e6.
Zou X, Chen K, Zou J, Han P, Hao J, Han Z. Single-cell RNA-seq data analysis on the receptor ACE2 expression reveals the potential risk of different human organs vulnerable to 2019-nCoV infection. Front Med. 2020;14:185-192.
Xu J, Li Y, Gan F, Du Y, Yao Y. Salivary glands: Potential reservoirs for COVID-19 asymptomatic infection. J Dent Res 2020;99:989.
Huang YH, Huang JT. Use of chlorhexidine to eradicate oropharyngeal SARS-CoV-2 in COVID-19 patients. J Med Virol 2021;93:4370-3.
Awadasseid A, Wu Y, Tanaka Y, Zhang W. Current advances in the development of SARS-CoV-2 vaccines. Int J Biol Sci 2021;17:8.
Kim ES, Chin BS, Kang CK, Kim NJ, Kang YM, Choi JP, et al. Clinical course and outcomes of patients with severe acute respiratory syndrome coronavirus 2 infection: A preliminary report of the first 28 patients from the Korean cohort study on COVID-19. J Korean Med Sci 2020;35:e142.
Moosavi MS, Aminishakib P, Ansari M. Antiviral mouthwashes: Possible benefit for COVID-19 with an evidence-based approach. J Oral Microbiol 2020;12:1794363.
Mottaghi R, Mianehsaz E. Prophylactic effects of mouthwashes on covid-19 and its family viruses: A systematic review. Qom Univ Med Sci J 2020;14:69-78.
Jain A, Grover V, Singh C, Sharma A, Das DK, Singh P, et al. Chlorhexidine: An effective anti-COVID mouth rinse. J Indian Soc Periodontol 2021;25:86.
Karpiński T, Szkaradkiewicz A. Chlorhexidine–pharmaco-biological activity and application. Eur Rev Med Pharmacol Sci 2015;19:1321-6.
Madeswaran S, Jayachandran S. Sodium bicarbonate: A review and its uses in dentistry. Indian J Dent Res 2018;29:672.
Mir MA, Mansoor S, Bhat A, Rehman MU, Ahmad A, Ahmad P. Lysosomotropic properties of sodium bicarbonate and covid-19. Farmacia 2020;68:771-8.
Zamani S, Zamani SH, Jouzi M. The effect of inhalation of sodium bicarbonate (soda fumigation) on the respiratory complications of Covid-19 disease: A review study. The first national conference of health knowledge production, confronting covid-19 and governing the post-corona world. 2020. Available from: https://civilica.com/ doc/1127326. [Last accessed 2023 Sep 08].
Siahpoosh MB, Habibi A, Nikbakht Nasrabadi A. Doubts about the Effectiveness of Baking Soda Inhalation on Improving Respiratory Symptoms in COVID-19 Patients: A Review Article. mhj [Internet] 2020;12:1-15. Available from: https://journals. sbmu.ac.ir/mh/article/view/32194. [Last accessed 2023 Sep 08].
Alshamrani MM, El-Saed A, Al Zunitan M, Almulhem R, Almohrij S. Risk of COVID-19 morbidity and mortality among healthcare workers working in a large tertiary care hospital. Int J Infect Dis 2021;109:238-43.
Bergwerk M, Gonen T, Lustig Y, Amit S, Lipsitch M, Cohen C, et al. Covid-19 breakthrough infections in vaccinated health care workers. N Engl J Med 2021;385:1474-84.
Yang H, Xie Y, Li C. Understanding the mechanisms for COVID-19 vaccine’s protection against infection and severe disease. Expert Rev Vaccines 2023;22:186-92.
Barouch DH. Covid-19 vaccines—immunity, variants, boosters. N Engl J Med 2022;387:1011-20.
Khoshkam Z, Aftabi Y, Stenvinkel P, Lawrence BP, Rezaei MH, Ichihara G, et al. Recovery scenario and immunity in COVID-19 disease: A new strategy to predict the potential of reinfection. J Adv Res 2021;31:49-60.
Common questions and what we should know about vaccines and vaccinations. 2020. Available from: http://www.behdasht. gov.ir. [Last accessed 2023 Jan 05].
Available from: https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html. [Last accessed 2022 Jan 30].
Available from: https://www.who.int/emergencies/diseases/ novel-coronavirus-2019/question-and-answers-hub/q-a-detail/ coronavirus-disease-covid-19. [Last accessed 2022 Jan 30].
Yoon JG, Yoon J, Song JY, Yoon S-Y, Lim CS, Seong H, et al. Clinical significance of a high SARS-CoV-2 viral load in the saliva. J Korean Med Sci 2020;35:e195.
Kumar N, Kumar A, Mahto M, Singh PK. Gargling with 7.5% sodium bicarbonate solution for sars-cov-2 viremia clearance: Our institutional clinical experience. Indian J Crit Care Med 2021;25:791.
Najafi MH, Taheri M, Mokhtari MR, Forouzanfar A, Farazi F, Mirzaee M, et al. Comparative study of 0.2% and 0.12% digluconate chlorhexidine mouth rinses on the level of dental staining and gingival indices. Dent Res J 2012;9:305.
Vergara-Buenaventura A, Castro-Ruiz C. Use of mouthwashes against COVID-19 in dentistry. Br J Oral Maxillofac Surg 2020;58:924-7.
De Paula Eduardo F, Corrêa L, Heller D, Daep CA, Benitez C, Malheiros Z, et al. Salivary SARS-CoV-2 load reduction with mouthwash use: A randomized pilot clinical trial. Heliyon 2021;7:e07346.
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