Use of chlorhexidine to eradicate oropharyngeal SARS-CoV-2 in COVID-19 patients

Area of Science:

• Infectious Diseases
• Virology
• Public Health

Background:

• Minimizing the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is crucial during the ongoing public vaccination efforts for coronavirus disease 2019 (COVID-19).
• Topical antimicrobial agents are being explored to supplement existing prevention strategies.

Purpose of the Study:

• To investigate the efficacy of chlorhexidine gluconate as a topical antimicrobial agent against SARS-CoV-2 in hospitalized patients.
• To evaluate the reduction of SARS-CoV-2 in the oral and oropharyngeal cavities using chlorhexidine.

Main Methods:

• A randomized, prospective cohort study was conducted involving hospitalized COVID-19 patients.
• Participants received either chlorhexidine as an oral rinse and/or posterior oropharyngeal spray alongside standard care, or standard care alone (control group).
• The primary outcome measured was the presence or absence of laboratory-confirmed SARS-CoV-2 after 4 days of treatment.

Main Results:

• Chlorhexidine oral rinse alone eliminated oropharyngeal SARS-CoV-2 in 62.1% of patients, compared to 5.5% in the control group.
• A combination of chlorhexidine oral rinse and oropharyngeal spray eliminated SARS-CoV-2 in 86.0% of patients, versus 6.3% in the control group.
• The study demonstrated a significant reduction in viral presence with chlorhexidine use.

Conclusions:

• Chlorhexidine gluconate is a safe and effective topical antimicrobial agent against SARS-CoV-2.
• Its use as an oral rinse and/or oropharyngeal spray can significantly reduce viral load in hospitalized patients.
• Chlorhexidine represents a valuable addition to current COVID-19 prevention guidelines, potentially playing a key role in reducing disease transmission.