ABSTRACT
OBJECTIVE: The objective of this study was to evaluate the efficacy and safety of using a hypertonic seawater nasal irrigation solution comprising natural ingredients (HSS-Plus) with the aim of reducing viral load and ameliorating nasal symptoms in cases of COVID-19. PATIENTS AND METHODS: This single-center, prospective, single-arm, low-intervention study evaluated daily use of HSS-Plus in patients admitted to the Sotiria Hospital, Athens, Greece for a period of up to 10 days or until hospital discharge. Viral load measurements in nasopharyngeal swabs were performed on days 0 (baseline), 3 and 6, and on the final day of participation (day 10 ± 2; hospital discharge). In addition, study participants were asked to rate the severity of nasal and other symptoms using Visual Analog Scales (VAS) at the same time points. At the final day, the patients also assessed the perceived use benefit of HSS-Plus. RESULTS: 47 patients were enrolled in the study; 93.6% had a decrease in viral load of at least > 0.5 log10 on day 10 (p<0.001). Compared to values before nasal irrigation, viral load in nasopharyngeal swabs increased immediately after nasal lavage on days 3 (p=0.037) and 6 (p=0.010), indicating efficient removal of viral particles from the nasal cavity. Mean VAS symptoms' total score was reduced from 27.57 ± 15.63 at baseline to 6.73 ± 6.59 after 10 days (p<0.001). Similar reductions were also evident for individual symptoms at all time points (p<0.005). No adverse events were reported in the study. CONCLUSIONS: HSS-Plus nasal irrigation is an effective and safe method for reducing viral load and providing symptom relief in patients with COVID-19.