Efficacy of physiological seawater nasal irrigation for the treatment of children with SARS-CoV-2 Omicron BA.2 variant infection: a randomized controlled trial.

BACKGROUND: Saline nasal irrigation is an effective therapy for relieving common cold symptoms. This study aimed to investigate and explore the efficacy of physiological seawater nasal irrigation (PSNI) on children with mild and asymptomatic infection with Omicron. METHODS: This randomized controlled trial was conducted in Shanghai, China, and 403 children with mild and asymptomatic infection with Omicron were included. These children were allocated into the PSNI group and the control group. The primary outcome was the duration of viral shedding (DVS), and the secondary outcome was the change in clinical symptoms. RESULTS: The median age of all participants was 5.59 (6.26) years old. The DVS was significantly shorter in the PSNI group [2.40 (1.13)] than in the control group [3.09 (2.14)] (P = 0.014). The multivariable Cox regression model also showed that patients in the PSNI group had an increased probability of shorter DVS compared with patients in the control group [hazard ratio (HR), 1.27; 95% confidence interval (CI), 1.04-1.55; P = 0.017]. Subgroup analysis suggested that the DVS of patients without full vaccination was significantly reduced in the PSNI group. The proportions of runny nose and stuffy nose were apparently reduced in the first three days in the PSNI group or the control group, but there was no evidence showing that PSNI contributes to the benefit compared with the control group. CONCLUSION: PSNI can reduce the DVS of patients with mild and asymptomatic infection with SARS-CoV-2 Omicron BA.2 variant.

Efficacy of buffered hypertonic seawater in different phenotypes of chronic rhinosinusitis with nasal polyps after endoscopic sinus surgery: a randomized double-blind study.

PURPOSE: Nasal douching is commonly used as a postoperative management strategy for chronic rhinosinusitis with nasal polyps (CRSwNP). Few studies to date have compared the effectiveness of nasal douching in CRSwNP phenotypes after endoscopic sinus surgery (ESS). We evaluated the efficacy of seawater types in eosinophilic CRSwNP (ECRSwNP) and noneosinophilic CRSwNP (nonECRSwNP) after ESS. METHODS: Patients with bilateral CRSwNP who had undergone ESS were blindly randomized to receive buffered hypertonic seawater (BHS) (n = 48) or physiological seawater (PS) (n = 45). CRSwNP patients were stratified by phenotypes (ECRSwNP and nonECRSwNP) retrospectively according to whether tissue eosinophils exceeded 10%. Follow-up evaluations were conducted at 2, 8, 16, and 24 weeks after surgery. Evaluations included the 22-item Sino-Nasal Outcome Test (SNOT-22), visual analog scale (VAS), Lund-Kennedy endoscopic score (LKES), saccharine clearance time (SCT), and adverse events. RESULTS: All of the patients experienced significant improvements in SNOT-22 scores, VAS scores, and LKES over time. BHS resulted in better improvement of LEKS and SCT relative to PS at 8 weeks postoperatively. Mucosal edema formation was significantly reduced with less crusting among HBS recipients at 8 weeks. After stratification, only patients in the nonECRSwNP + BHS subgroup showed a significant improvement in LEKS and SCT at 8 weeks postoperatively. Side effect profiles were not significantly different among the groups. CONCLUSIONS: BHS has a better inhibitory effect on mucosal edema and crusting during the early postoperative care period of CRSwNP. Among all of the patients, nonECRSwNP patients showed a significant improvement in LEKS and SCT at 8 weeks.

Clinical Study on Oral Loratadine Combined with Physiological Seawater Nasal Irrigation in the Treat-ment of Intermittent Allergic Rhinitis / 中国药房

OBJECTIVE:To investigate clinical efficacy and safety of oral loratadine combined with physiological seawater na-sal irrigation in the treatment of intermittent allergic rhinitis. METHODS:Totally 300 patients with intermittent allergic rhinitis were chosen from the Second Hospital of Hebei Medical University during Jan. 2013-Jun. 2015,and then divided into group A,B,C ac-cording to lottery method,with 100 cases in each group. Group A was given Loratadine tablets 10 mg,po,qd. Group B received nasal irrigation with physiological seawater nasal spray,every morning and evening. Group C was given oral loratadine combined with physiological seawater nasal irrigation. Treatment courses of 3 groups lasted for 28 d. Clinical efficiencies of 3 groups were compared as well as symptom and sign scores,respiration function indexes and inflammatory factor levels before and after treat-ment,and the clinical recurrences were followed up for 12 months. RESULTS:The total response rates of group A,B,C were 80.00%,78.00%,96.00%,respectively,and that of group C was significantly higher than that of group A and B,with statistical significance(P0.05). After treatment,symptom and sign scores,the rates of PEF diur-nal variation,TNF-α,INF-γ and IL-4 in 3 groups were significantly lower than before treatment,and the levels of PEF and IL-12 were significantly higher than before treatment. Above indexes of group C were significantly better than those of group A and B, with statistical significance (P0.05). CONCLUSIONS:Oral loratadine combined with physiological seawater nasal irrigation in treatment of intermittent allergic rhinitis can efficiently relieve the nasal symptoms and signs,improve expiratoryfunction,reduce the inflammatory response levels and be help-ful to reduce the long-term recurrence risk.