A Cetylpyridinium Chloride Oral Rinse Reduces Salivary Viral Load in Randomized Controlled Trials

Area of Science:

• Virology
• Infectious Diseases
• Public Health

Background:

• SARS-CoV-2 transmission occurs via salivary and respiratory secretions.
• Reducing salivary viral load is a strategy to mitigate transmission, especially in healthcare settings.
• Novel SARS-CoV-2 variants necessitate ongoing transmission control measures.

Purpose of the Study:

• To evaluate the antiviral efficacy of commercially available mouthrinses against SARS-CoV-2 in saliva.
• To determine if specific mouthrinse ingredients can reduce salivary viral load in COVID-19 patients.
• To assess patient willingness to use mouthrinses in clinical settings.

Main Methods:

• Two double-blind randomized controlled trials were conducted.
• Participants with recent COVID-19 infection used various FDA-approved mouthrinses (ethanol, hydrogen peroxide, povidone iodine, chlorhexidine gluconate, CPC, or saline).
• Salivary SARS-CoV-2 viral load was quantified using qPCR at baseline, 30, and 60 minutes post-rinsing.

Main Results:

• A mouthrinse containing cetylpyridinium chloride (CPC) significantly reduced salivary SARS-CoV-2 viral load at 30 minutes post-rinsing compared to baseline.
• No other tested mouthrinse showed a significant reduction in viral load at 30 minutes.
• Salivary viral load showed a rebound by 60 minutes post-rinsing across all groups, with no significant reduction from baseline.

Conclusions:

• Preprocedural oral rinsing with CPC-containing mouthwash is a feasible and inexpensive method to temporarily reduce salivary SARS-CoV-2 viral load.
• This approach may help mitigate the spread of SARS-CoV-2 and other enveloped viruses during clinical procedures.
• Patients expressed willingness to use oral rinses in healthcare settings to reduce transmission risk.