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The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was funded by Dentaid S.L. The authors acknowledge the crowdfunding initiative #Yomecorono (www.yomecorono.com).N.Izquierdo-Useros is supported by grant PID2020-117145RB-I00 from the Spanish Ministry of Science and Innovation.

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Cetylpyridinium Chloride Mouthwash to Reduce Shedding of Infectious SARS-CoV-2: A Double-Blind Randomized Clinical Trial

Publicated to:Journal Of Dental Research. 101 (12): 1450-1456 - 2022-11-01 101(12), DOI: 10.1177/00220345221102310

Authors: Alemany, A; Perez-Zsolt, D; Raïch-Regué, D; Muñoz-Basagoiti, J; Ouchi, D; Laporte-Villar, C; Baro, B; Henríquez, N; Prat, N; Gianinetto, MO; Gutiérrez, MV; Sánchez-Paniagua, MG; Henríquez, NL; Vicente, JM; Ara, J; Rodriguez-Arias, MA; Puig, J; Blanco, ; Lopez, CC; Hernández, A; Bordoy, AE; Redondo, CE; Soler, VG; Giménez, M; Blanc, ; León, R; Gispert, J; Clotet, B; Izquierdo-Useros, N; Mitjà, O

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Abstract

The airborne transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) via respiratory fluids and droplets suggests that mouthwashes containing substances with virucidal activity can help reduce viral spread. We conducted a multicenter, double-blind, placebo-controlled, randomized trial to assess the virucidal activity of cetylpyridinium chloride (CPC) mouthwashes. Outpatients who tested positive for SARS-CoV-2 infection with or without symptoms were randomized to perform washes and gargles for 1 min with 15 mL of either colored distilled water or 0.07% CPC (Vitis CPC Protect) mouthwash. The study outcomes were the SARS-CoV-2 log(10) viral RNA load and the nucleocapsid protein levels, both in saliva at 1 and 3 h after the intervention. In total, 118 patients were enrolled and randomized (mean [SD], age 46 [14] y). Thirteen of 118 participants (11%) did not complete follow-up or had insufficient sample volume for testing and were excluded from the analysis. The assessment of the viral load showed no significant differences between groups at any of the investigated points. However, the levels of SARS-CoV-2 nucleocapsid protein of lysed viruses were significantly higher in the CPC group compared with the control group at 1 h (adjusted difference 269.3 pg/mL; 95% confidence interval [CI], 97.1-441.5) and at 3 h postintervention (561.1 pg/mL; 95% CI, 380.0-742.2). In nonhospitalized patients with asymptomatic or mild symptomatic SARS-CoV-2 infection, a 0.07% CPC mouthwash, compared to placebo, was associated with a significant increase of nucleocapsid protein levels in saliva, indicating enhanced disruption of viral particles.

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