Evaluation of virucidal efficacy of 0.5% Povidone iodine (PI), 0.2% Chlorhexidine (CHX) and 1.5% Hydrogen peroxide (H2O2) antiseptic rinse on tongue decontamination in SARS CoV-2 Patients

Abstract

Background: SARS CoV-2 spreads rapidly through respiratory droplets, saliva, or direct    contact. 
Oral cavity acts as the gateway with tongue and oral mucosa showing increased expression of 
angiotensin converting enzyme-2(ACE-II) molecules onto which the virus binds. The simplest way to 
prevent the cross contamination there by reducing transfer is by adopting effective oral hygiene 
measures to reduce the viral load. Hence the present study aims to evaluate the efficacy of three different 
antiseptic rinse used in dental clinics in reducing the severe acute respiratory syndrome coronavirus-2 
(SARS CoV-2) transfer. 
Methods: The study was conducted on 32 mild symptomatic SARS CoV -2 Real time reverse 
transcription polymerase chain reaction (RT-PCR) positive patients (18 females and 14 males) with the 
mean age group of 40.3±12.7, who were advised isolation. Patients were grouped into four categories 
each consisting of 8 patients. Group A patients were provided with 0.5% of Povidone iodine (PI) mouth 
rinse, where Group B were advised 0.2% Chlorhexidine rinse (CHX), Group C were given 1.5% 
Hydrogen peroxide (H2O2) while the control group were advised water rinse. Tongue scrapings were 
collected using a sterile swab at the baseline, first week and at the end of second week. Samples were 
transferred to the viral transport media for the real time reverse transcription polymerase chain reaction 
to assess the presence of the virus along with the assessment of viral cycle threshold (Ct). 
Results: A significant reduction was noted in all the three mouth rinses group except for the control. 
Statistically significant reduction (P value - 0.000) in the positivity rate was observed in 0.2% CHX 
group on the 7th day while the PI group fared better than the H2O2 group or control. At the end of 2 
week however all the groups exhibited viral inactivity. Chlorhexidine 0.2% rinse group (n=8) showed 
greater reduction in the viral threshold with a better virucidal action from the early days of infectivity 
suggesting its effectiveness against SARS COV-2. 
Conclusion: Within the limitation of the study it can be inferred that usage of 0.2% chlorhexidine mouth 
rinse is effective in reducing the SARS CoV-2 virus threshold and hence can be a potential aid in 
affected individuals in preventing further transmission of the virus.