ABSTRACT
Objectives The medical and health facilities are at high risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This study tested the preprocedural prophylactic mouthwash rinses to reduce the oral viral load. The findings from this study will help the practitioners to select the best mouthwash for the patients to mitigate the risk of transmission during aerosolizing. This study aimed to evaluate the effectiveness of four commonly used types of mouthwash in reducing intraoral viral load among hospitalized coronavirus disease 2019 patients. Materials and Methods This prospective cohort study was conducted with 116 patients referred to the Masih Daneshvari Hospital in Tehran, Hamadan University of Medical Sciences of Hamadan City, and Mashhad University of Medical Sciences. Patients were randomized into four groups with each group rinsed their mouth with 20 mL of 2% povidone-iodine, 1% hydrogen peroxide, normal saline as a control study group, or 0.12% chlorhexidine, respectively, for 20 seconds. The standard reverse transcription polymerase chain reaction method evaluated the virus load before and at 1 hour, 2 hours, and 4 hours after using the mentioned mouthwash. Results Our results revealed that chlorhexidine and H 2O 2showed the highest efficiency in reducing SARS-Co-2 load in the oral cavity and nasopharyngeal region of patients;they increased the Ct values by 9 to 10 (before: 25.84 vs. after 32. 4, p < 0.455) (17.333 vs. after 26.497, p <0.097). Conclusion Our findings suggest that chlorhexidine and H 2O 2could be used in dental clinics to reduce the risk of transmitting the SARS-CoV-2 virus from infected individuals to dentists before dental procedures. © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
ABSTRACT
Coronavirus disease 2019 (COVID-19), as a dangerous global pandemic, has led to high morbidity and mortality in all countries. There is a lot of evidence for the possible role of oxidative stress in COVID-19. In the present study, we aimed to measure the levels of glutathione (GSH), total antioxidant capacity (TAC) and total oxidant status (TOS) in the serum of patients with COVID-19. A total of 96 individuals with and without COVID-19 were enrolled and divided into four groups, including hospitalised group in non-intensive care units (non-ICU) (n = 35), hospitalised group in intensive care units with endotracheal intubation (EI) (ICU with EI) (n = 19), hospitalised group in intensive care units without endotracheal intubation (ICU without EI) (n = 24) and healthy people without COVID-19 disease as our control group (n = 18). The present study revealed that the TOS level was significantly lower in the group of control (p = 0.001), and level of GSH remarkably increased in the patients' groups (p < 0.001). TAC activity in non-ICU group of patients had no significant difference in comparison with the control group. However, in hospitalised patients' groups in the ICU with and without EI this activity was significantly different from the control group (p < 0.001). Moreover, there was a significant relationship between the levels of TOS, GSH and TAC with blood oxygen saturation (SpO2), fever, duration of hospitalisation and the prognosis of this disease (p < 0.001). Area under the curve (CI, 95%) of TOS, TAC and GSH-C to predict death among patients were, respectively, 0.907 (0.841, 0.973), 0.735 (0.626, 0.843) and 0.820 (0.725, 0.914). Receiver operating characteristic curve analysis showed that TOS, TAC and GSH-C have the potential specificity and sensitivity to distinguish between alive and dead patients. We found that elevated levels of oxidative stress and reduction of antioxidant indices can aggravate disease's severity in hospitalised patients with COVID-19. Therefore, it can be suggested to apply antioxidant agents as one of the effective therapeutic strategies in these groups.