Nasopharyngeal Wash with Normal Saline Decreases SARS-CoV-2 Viral Load: A Randomized Pilot Controlled Trial

Area of Science:

• Virology
• Infectious Diseases
• Respiratory Medicine

Background:

• Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to pose a global health challenge.
• Emerging variants and persistent high morbidity/fatality rates necessitate affordable strategies to reduce viral transmission.
• Previous research indicated saline solutions can reduce microbial antigens and burden in non-COVID-19 patients.

Purpose of the Study:

• To evaluate the efficacy of normal saline (0.9%) nasal washes in reducing nasopharyngeal viral load in hospitalized COVID-19 pneumonia patients.
• To assess the impact of nasal saline irrigation on viral load dynamics during hospitalization.

Main Methods:

• A prospective, randomized, pilot, controlled trial involving 50 COVID-19 patients.
• Patients were assigned to either a normal saline nasal wash group (every 4 hours for 16 hours) or a control group (no treatment).
• Nasopharyngeal swabs were collected at baseline and 24 hours post-intervention for SARS-CoV-2 viral load assessment via cycle threshold (Ct) values.

Main Results:

• The normal saline group showed a significant increase in mean N gene Ct values (1.87 cycles, p=0.007), indicating an 8.9% decline in viral load.
• The control group exhibited a significant decrease in mean N gene Ct values (-2.12 cycles, p<0.001), indicating a 9.7% increase in viral load.
• A statistically significant difference in viral load change was observed between the groups (3.09 cycles, p=0.005).

Conclusions:

• Normal saline nasal washes were effective in decreasing SARS-CoV-2 nasopharyngeal viral load in hospitalized patients.
• This method demonstrated a significant reduction in viral load compared to the control group.
• Nasal saline irrigation presents a viable strategy for managing viral load during COVID-19 hospitalization.