Evidence map›Paper›PMID 37821800›Full record

SynthesisBMC infectious diseases2023

Efficacy of mouthwash on reducing salivary SARS-CoV-2 viral load and clinical symptoms: a systematic review and meta-analysis.

Mingrui Zhang, Nan Meng, Hong Duo, Yuanbo Yang, Qing Dong, Jianqi Gu

Open access · goldAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in BMC infectious diseases, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
5.9field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 12 citations in OpenAlex.

  1. Trial
  2. Review
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 1 country.

Mingrui ZhangNorth China University of Science and Technology, No. 21, Bohai Avenue, Caofeidian New Town, Tangshan City, 063000, Hebei, China.
Nan MengNorth China University of Science and Technology, No. 21, Bohai Avenue, Caofeidian New Town, Tangshan City, 063000, Hebei, China.
Hong DuoDepartment of Critical Care Medicine, Zhongnan Hospital of Wuhan University, The Second Clinical College of Wuhan University, Wuhan, 430071, China.
Yuanbo YangDepartment of Stomatology, Tangshan Workers Hospital, Tangshan, 063000, Hebei, China.
Qing DongNorth China University of Science and Technology, No. 21, Bohai Avenue, Caofeidian New Town, Tangshan City, 063000, Hebei, China. dongqing@ncst.edu.cn.
Jianqi GuDepartment of Stomatology, HeBei General Hospital, Shijiazhuang, 050000, Hebei, China. gujq829@163.com.
North China University of Science and Technology · CNHebei General Hospital · CNTangshan People's Hospital · CNZhongnan Hospital of Wuhan University · CN

Funding

Key Research and Development Program in Hebei Province of China 22377741D
6 · The paper itself

Abstract

backgroundCOVID-19 has been a public health emergency of international concern (PHEIC) for a lengthy period of time. The novel coronavirus is primarily spread via aerosols at a short distance, with infected individuals releasing large amounts of aerosols when speaking and coughing. However, there is an open question regarding whether mouthwash could effectively reduce virus transmission during the COVID-19 pandemic and support the prevention of infection among medical workers.

methodsCochrane Library, PubMed, Web of Science, and Embase databases were systematically searched from the inception of each database to January 12, 2023 for currently available randomized clinical trials (RCTs) on the effect of mouthwash on novel coronavirus load in the oral cavity in COVID-19 patients. The treatment group received mouthwash for rinsing the mouth, while the control group received a placebo or distilled water for COVID-19 patients. The primary outcomes were CT value and viral load. Odds ratios (ORs) were estimated using a random-effects model. Subgroup and sensitivity analyses were performed to minimize the bias and the impact of heterogeneity.

resultsThirteen RCTs were included. Seven studies reported the intervention effect of mouthwash on the CT value of novel coronavirus. The analysis results showed that the mouthwash group had a positive impact on the CT value of novel coronavirus [ SMD = 0.35, 95% CI (0.21, 0.50)] compared with the control group. In addition, subgroup analysis showed a significant positive effect of mouthwash on CT values in the treatment group compared with the control group, with chlorhexidine (CHX) [SMD = 0.33, 95% CI (0.10, 0.56)], povidone-iodine (PVP-I) [SMD = 0.61, 95% CI (0.23, 0.99)], or hydrogen peroxide (HP) [SMD = 1.04, 95% CI (0.30, 1.78)] as an ingredient of the mouthwash. Six studies reported the intervention effect of mouthwash on the viral load, 263 cases in the treatment group and 164 cases in the control group. The analysis results showed that there was no statistical difference between the mouthwash group and the control group in the viral load of novel coronavirus [SMD = -0.06, 95% CI (-0.18, 0.05)]. In the subgroup analysis by measurement time, there were statistically significant differences between the mouthwash and control groups for CT values [SMD = 0.52, 95% CI (0.31, 0.72)] and viral load [SMD =  - 0.32, 95% CI (- 0.56, - 0.07)] within 30 min of gargling.

conclusionsIn summary, mouthwash has some efficacy in reducing the viral load of novel coronavirus, especially within 30 min after rinsing the mouth. Mouthwash containing CHX, PVP-I and HP all had significant positive effects on CT values, and PVP-I-containing mouthwash may be a promising option to control novel coronavirus infections and relieve virus-related symptoms. However, studies on the dose and frequency of use of mouthwash for infection control are still lacking, which may limit the clinical application of mouthwash.

trial registrationProtocol registration: The protocol was registered at PROSPERO (CRD42023401961).

Indexed as

COVID-19MouthwashesChlorhexidineHumansHydrogen PeroxidePovidone-IodineRespiratory Aerosols and DropletsSARS-CoV-2Viral LoadChlorhexidineHydrogen PeroxideMouthwashesPovidone-IodineCOVID-19MouthwashPovidone-iodineRandomized controlled trialsVirus transmission

Identifiers

PMID37821800
PMCPMC10568889
OpenAlexW4387529170

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.