This article explores the potential benefits and harms of using antimicrobial mouthwashes and nasal sprays to protect healthcare workers and improve outcomes for patients with suspected or confirmed COVID-19 infections, but currently there is no evidence available to draw any conclusions.

- Several clinical trials are investigating the use of mouthwashes and nasal sprays to improve outcomes for patients with COVID-19 and to protect healthcare workers treating them. - The trials are testing various solutions, including saline, povidone iodine, and chlorhexidine. - The primary outcomes being measured include viral load, oxygen requirement, and oxygen saturation. - Some trials are also assessing symptom severity and time to clinical recovery. - The trials have varying sample sizes and inclusion/exclusion criteria.

This is from Cochrane Database of Systematic Reviews in 2021 at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8187985/.

A study found that hypochlorous acid nasal spray was as effective as saline nasal irrigation in treating chronic rhinosinusitis patients who had undergone functional endoscopic sinus surgery, and could be a convenient alternative in post-surgery care.

- Hypochlorous acid (HOCl) nasal spray is as effective as saline nasal irrigation in treating chronic rhinosinusitis (CRS) in patients who have undergone functional endoscopic sinus surgery (FESS). - HOCl nasal spray is convenient to use and can be an alternative to saline nasal irrigation in post-FESS care. - The study found a significant reduction in endoscopic score after 2 months of HOCl nasal spray. - The study found a significant reduction in TWSNOT-22 score after normal saline (NS) nasal irrigation.

This is from Am J Otolaryngol in 2022 at https://ciplamed-library.com/content/can-hypochlorous-acid-nasal-spray-be-an-alternative-to-saline-nasal-irrigation-in-crs.

This study investigated the effectiveness of using Physiomer, an undiluted seawater nasal spray, to reduce the duration of nasal symptoms in adults with mild to moderate COVID-19 or URTIs, by mechanically evacuating nasal secretions containing the viruses and reducing contact time between the viruses and the nasal mucosa.

- Physiomer, an undiluted isotonic seawater nasal spray, may reduce the duration of nasal symptoms caused by mild to moderate COVID-19 and URTIs. - Nasal saline irrigations can reduce the duration of infectious episodes and relieve symptoms of upper respiratory tract infections (URTIs) caused by various respiratory viruses including coronaviruses. - Preliminary data showed that daily nasal wash can significantly reduce symptom duration in subjects with mild and moderate forms of COVID-19. - The study will take place in France among adults subjects who developed nasal obstruction and rhinorrhea no more than 48 hours before study inclusion. - The study will evaluate the effectiveness of Physiomer on reducing the duration of nasal symptoms (nasal obstruction or rhinorrhea) in subjects with mild to moderate COVID-19 and URTIs.

This is from Clinical Trials Registry in 2023 at https://ichgcp.net/clinical-trials-registry/NCT04916639.

The use of hypochlorous acid nasal spray after functional endoscopic sinus surgery showed similar efficacy to normal saline nasal irrigation, and may be a convenient alternative for postoperative care.

- Hypochlorous acid (HOCl) nasal spray is effective as an adjuvant therapy after functional endoscopic sinus surgery (FESS). - HOCl nasal spray had a similar effect to that of normal saline (NS) nasal irrigation in post-FESS care. - HOCl nasal spray can be an alternative to NS nasal irrigation for post-FESS care due to its convenient application.

This is from International Journal of Pediatric Otorhinolaryngology in 2021 at https://www.sciencedirect.com/science/article/abs/pii/S0196070921003653.

A study found that a nasal spray reduced the risk of SARS-CoV-2 infection compared to placebo and was well-tolerated, offering a novel treatment option for prophylaxis against COVID-19, according to a randomized trial published in the Journal of Clinical Virology. The spray was developed by Raphael Labs Ltd and Dabur Research Foundation and combines natural virucidal agents with a patented system designed to alter the optimal acidic environment required for cell invasion, hence preventing viral entry into the nasal epithelium. The study's primary endpoint was the percentage of subjects who tested positive for IgGS (anti-spike, immunoglobulin G specific to the spike protein of SARS-CoV-2) at day 45.

- A study was conducted to evaluate the efficacy and safety of a novel prophylactic nasal spray in the prevention of SARS-CoV-2 infection. - The study was multi-centre, double blind, placebo-controlled, and randomised. - The study found that the nasal spray was effective in inhibiting in vitro SARS-CoV-2 infection and spread. - Other studies have also investigated the use of nasal sprays and mouthwashes as a preventive measure against COVID-19. - The studies suggest that nasal sprays containing iota-carrageenan or IgM antibodies may offer broad protection against SARS-CoV-2 variants.

This is from J Clin Virol in 2022 at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9313533/.

Nasal sprays are being explored as a potential method for preventing and treating COVID-19, as they offer advantages such as needle-free administration, self-administration, and ease of use, and can target the upper respiratory tract where the virus initially invades. However, further research and clinical trials are needed to determine their effectiveness.

This is from PMC in 2023. You can find the article here.

Saline nasal irrigation can be an effective treatment for chronic rhinosinusitis, and may also be helpful for managing symptoms of mild to moderate allergic rhinitis and acute upper respiratory tract infections, according to consensus guidelines, although more research is needed to confirm its effectiveness for these conditions. Saline nasal irrigation is generally considered safe and can be easily performed at home with a neti pot or nasal spray bottle.

- A patient with leg pain that worsens with standing and improves with bending forward has a 75% probability of having lumbar spinal stenosis. - Carbamazepine, phenobarbital, phenytoin, lamotrigine, sodium valproate, and topiramate are effective in controlling seizures in newly diagnosed partial or generalized epilepsy. - Adding second-line drugs to usual treatment reduces seizure frequency in persons with drug-resistant partial epilepsy, but increases adverse effects such as dizziness and somnolence. - In persons who have been seizure-free for at least two years while on treatment, almost 60 percent of those who withdraw from antiepileptic treatment remain seizure-free, compared with almost 80 percent of persons who continue treatment. - High-dose supplemental vitamin D (482 to 770 IU per day) can reduce risk of nonvertebral fractures by at least 20 percent, and hip fractures by at least 18 percent. - Caffeine intake is directly correlated with small but notable fetal growth restriction. Although a safe threshold cannot be determined, maternal caffeine intake of less than 100 mg per day minimizes the risk of fetal growth restriction. - Patients started on rosiglitazone have higher rates of all-cause mortality and hospitalization for CHF than those using pioglitazone. The risks of MI or stroke are comparable for the two drugs.

This is from American Family Physician in 2009 at https://www.aafp.org/pubs/afp/issues/2009/1115/p1117.html.

Saline nasal spray can help alleviate allergy symptoms by restoring moisture to dry nasal passages, thinning mucus, and cleansing nasal passages of pollen and other allergens, but it's important to use it correctly and consult with a doctor if unsure.

- Saline nasal spray can help with nasal allergies by restoring moisture to dry nasal passages and sinuses, curbing inflammation of mucous membranes, thinning mucus, giving less postnasal drip, and cleansing nasal passages of pollen and other allergens. - Over-the-counter saline sprays and rinses can help remove pollen from the nasal lining and add moisture if your nose feels dry from winter weather. - You can easily make a saline solution at home to wash your nose and sinuses using non-iodized salt and baking soda. - If you use a nasal steroid spray to treat your allergies, doctors suggest you first use a saline spray to cleanse the nose and rid it of thick mucus and debris. - Talk to your doctor or allergist if you're not sure how to use saline nasal spray correctly.

This is from Webmd in 2023 at https://www.webmd.com/allergies/saline-spray

This study aims to evaluate the effectiveness of a seawater nasal spray in reducing the duration of nasal symptoms of COVID-19 and reducing the SARS-CoV-2 viral load in subjects with mild to moderate COVID-19, and the study will take place in France among adults subjects with mild to moderate COVID-19 who developed nasal obstruction and rhinorrhea no more than 48 hours before study inclusion.

- A medical trial is being conducted to assess the efficacy of a natural seawater nasal spray, Physiomer®, to reduce duration of COVID-19 nasal symptoms and reduce SARS-CoV-2 viral load in subjects with mild to moderate COVID-19 disease. - Nasal saline irrigations are frequently prescribed for both prevention and treatment of upper respiratory tract infections (URTIs). - The sponsor hypothesized that the daily use of seawater nasal wash in subjects with mild to moderate forms of COVID-19 would relieve nasal symptoms caused by SARS-CoV-2 virus, including nasal obstruction and rhinorrhea, and would reduce the intranasal viral load. - The study will take place in France among adults subjects with mild to moderate COVID-19 who developed nasal obstruction and rhinorrhea no more than 48 hours before study inclusion. - Subjects positive for SARS-CoV-2 will be randomized into one of two study groups: control group or nasal wash group. - Subjects in the nasal wash group will be asked to perform daily nasal wash for a 3 weeks period with Physiomer®, a 100% seawater isotonic nasal spray. - Subjects in both groups will complete daily online questionnaires for a 3 weeks period. - The main objective of this study is to evaluate the effectiveness of Physiomer®, an undiluted isotonic seawater nasal spray, on reducing the duration of nasal symptoms of COVID-19 (nasal obstruction or rhinorrhea) in subjects with mild to moderate COVID-19. - The study is estimated to start on May 27, 2021, and end on October 27, 2021.

This is from ClinicalTrials.gov in 2023 at https://clinicaltrials.gov/ct2/show/NCT04916639.

Researchers at Stanford Medicine have identified the routes that the COVID-19 virus takes to enter and exit cells in the nasal cavity, which could lead to the development of a nasal spray to prevent infection; the virus attaches itself to cilia and microvilli structures found on multiciliated epithelial cells, which form a protective barrier to keep viruses from entering the airway, and the researchers found that inhibiting ciliary motion or microvilli gigantism could prevent respiratory viruses from colonizing the nose and throat, potentially limiting future pandemics.

- SARS-CoV-2 takes specific routes to enter and exit cells in our nasal cavity - Cilia and microvilli are two structures found on multiciliated epithelial cells that are involved in the virus's entry and exit - Cilia are appendages that the virus initially attaches to, while microvilli enlarge and branch to release attached viral progeny to spread to other cells - Human ciliated nasal epithelial cells are the primary entry site for SARS-CoV-2 in nasal epithelial tissue - Eliminating mucin from the mesh prevents the mesh from blocking SARS-CoV-2 infection of the organoids - Inhibiting viral entry or exit in airway cells could prevent unknown respiratory viruses from making themselves at home in your nose or throat

This is from Cell in 2023 at https://med.stanford.edu/news/all-news/2023/01/covid-virus-infection-nasal.html.

To further protect against COVID-19, dental professionals should consider using a nasal barrier cream or spray to reduce the viral load originating from the nose, which is the primary site of respiratory infection, as shown by studies indicating that molecular iodine is effective as an antimicrobial agent and can reduce the viral load to below the limits of detectability.

- The nose is the primary site of COVID-19 respiratory infection and the virus is exhaled from infected individuals in normal breathing. - Higher viral loads are found in the nasal passages than in the mouth. - Nasal hygiene is important to minimize the viral load from the nasal passages of infected patients. - Swabbing the internal surfaces of the patient's nostrils with an effective antimicrobial cream provides additional protection. - Antimicrobial prerinses are effective in reducing microbial aerosols.

This is from RDH in 2023 at https://www.rdhmag.com/infection-control/article/14206284/the-need-for-covid19-nasal-protection-is-as-plain-as-the-nose-on-your-face.

The COVICONTROL study is a clinical trial evaluating the efficacy and safety of a nasal and mouth spray containing hypochlorous acid in treating hospitalized and symptomatic SARS-CoV-2 positive patients, and is estimated to enroll 400 participants and be completed in September 2023.

- The study aims to evaluate the efficacy and safety of nasal and mouth spray application with hypochlorous acid-containing solution versus placebo as a curative treatment for hospitalized and symptomatic SARS-CoV-2 positive patients. - The COVICONTROL study is a prospective, multicenter, randomized, controlled, double-blind study. - The study will be conducted in Tunisia at the COVID patient management centers in the emergency departments of Monastir (Fattouma Bourguiba) and Sousse (Hospital Of Sahloul). - The study will enroll 400 participants. - Patients will receive either a spray of solution containing hypochlorous acid or a placebo according to the predetermined randomization. - The primary endpoint in all included patients is the change in viral load between Day 1 and Day 3. - The secondary endpoints include duration of symptoms, need for hospitalization, need for intensive care, need for ventilatory support, and contamination. - Patients with symptoms of COVID who are over 18 years of age and whose nasal swabs have been positive for SARS-CoV-2 based on RT-PCR testing less than 3 days are eligible to participate. - Patients must have the ability to understand and be willing to sign a written informed consent document from the patient or legal representative.

This is from clinicaltrials.gov in 2023 at https://clinicaltrials.gov/ct2/show/NCT05862480.

This medical trial aims to test the safety and effectiveness of hypochlorous acid as a nasal spray to reduce the risk of SARS-CoV-2 infection in high-risk health personnel, and could potentially contribute to controlling the COVID-19 pandemic.

- Hypochlorous acid (HClO) could contribute to reducing the viral load and the risk of contamination of patients and professionals. - The therapeutic uses of HClO began in the First World War and its safety has been proven in preclinical trials. - HClO has been tested against enveloped and non-enveloped viruses, reducing virus particles without affecting human cells. - A RCT with the use S-HClO as a prevention treatment for the infection by SARS-CoV-2 in health professionals is proposed.

This is from a clinical trial in 2023 at https://clinicaltrials.gov/ct2/show/NCT04684550.

Saline irrigation can help ease sinus congestion, reduce allergy symptoms, and may play a role in COVID-19 recovery; it is an easy-to-use and widely available non-drug option that can save lives, and can be done with a neti pot or nasal spray.

- Saline irrigation can help ease sinus congestion and may also play an important role in recovery from COVID-19. - Saline nasal rinsing is an effective, inexpensive way to reduce allergy symptoms. - Nasal irrigation with saline can be helpful in cases of chronic sinus irritation. - You don’t have to use a neti pot to ease sinus congestion. You can use a more modern system of nasal irrigation, such as one made by NeilMed.

This is from Ear, Nose & Throat Journal in 2022 at https://pubmed.ncbi.nlm.nih.gov/36007135/.