ABSTRACT
Objectives To evaluate the clinical outcome, such as length of hospital stay (LOS), need for referral to the intensive care unit (ICU), and number of deaths of patients with COVID-19 with the use of a mouthwash containing a phthalocyanine derivative. Study Design A randomized triple-blind clinical trial in which a total of 41 hospitalized patients with COVID-19 were followed up. Patients were divided into 2 groups and both received a mouthwash containing active (AM) and nonactive (NAM) ingredients. They were instructed to use mouthwash and gargle for 1 minute 5 times a day and continue using the solution until discharge. Results The median LOS of the AM group was significantly shortened (4 days) compared with the NAM group (7 days;P = .0314). Additionally, gargling/rinsing with anionic phthalocyanine derivative was very helpful in reducing the severity of symptoms (no ICU care was needed) compared to not gargling/rinsing with APD (28.6% of patients in the NAM group needed ICU care, and 50% of this ICU subgroup died;P = .0207). Conclusions This study showed that the action of the mouthwash containing phthalocyanine derivatives had effects against SARS-CoV-2 and can reduce the symptoms of patients and reduce the length of hospital stay.
ABSTRACT
Mutations at both the receptor-binding domain (RBD) and the amino (N)-terminal domain (NTD) of the SARS-CoV-2 Spike (S) glycoprotein can alter its antigenicity and promote immune escape. We identified that SARS-CoV-2 lineages circulating in Brazil with mutations of concern in the RBD independently acquired convergent deletions and insertions in the NTD of the S protein, which altered the NTD antigenic-supersite and other predicted epitopes at this region. These findings support that the ongoing widespread transmission of SARS-CoV-2 in Brazil is generating new viral lineages that might be more resistant to neutralization than parental variants of concern.