Evidence map›Paper›PMID 38664718›Full record

Trial reportBMC oral health2024

Oral mouthwashes for asymptomatic to mildly symptomatic adults with COVID-19 and salivary viral load: a randomized, placebo-controlled, open-label clinical trial.

Daisuke Onozuka, Satoko Takatera, Hiroo Matsuo, Hisao Yoshida, Shigeto Hamaguchi, Shungo Yamamoto, Ryuichi Minoda Sada, Koichiro Suzuki, Keiji Konishi, Satoshi Kutsuna

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMC oral health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
4.3field-weighted citation impact, top 7% 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

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
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

10 authors at 3 institutions in 1 country.

Daisuke OnozukaDepartment of Oral Microbe Control, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Osaka, 565-0871, Osaka, Japan. onozukad@hp-infect.med.osaka-u.ac.jp.
Satoko TakateraDepartment of Oral Microbe Control, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Osaka, 565-0871, Osaka, Japan.
Hiroo MatsuoDepartment of Infection Control and Prevention, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Osaka, 565-0871, Osaka, Japan.
Hisao YoshidaDepartment of Infection Control and Prevention, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Osaka, 565-0871, Osaka, Japan.
Shigeto HamaguchiDepartment of Infection Control and Prevention, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Osaka, 565-0871, Osaka, Japan.
Shungo YamamotoDepartment of Infection Control and Prevention, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Osaka, 565-0871, Osaka, Japan.
Ryuichi Minoda SadaDepartment of Infection Control and Prevention, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Osaka, 565-0871, Osaka, Japan.
Koichiro SuzukiThe Research Foundation for Microbial Diseases of Osaka University (BIKEN), Osaka, Japan.
Keiji KonishiDepartment of Oral Microbe Control, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Osaka, 565-0871, Osaka, Japan.
Satoshi KutsunaDepartment of Oral Microbe Control, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Osaka, 565-0871, Osaka, Japan. kutsuna@hp-infect.med.osaka-u.ac.jp.
The University of Osaka · JPOsaka University of Human Sciences · JPKyoto Biken Laboratories (Japan) · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRecent randomized clinical trials suggest that the effect of using cetylpyridinium chloride (CPC) mouthwashes on the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load in COVID-19 patients has been inconsistent. Additionally, no clinical study has investigated the effectiveness of on-demand aqueous chlorine dioxide mouthwash against COVID-19.

methodsWe performed a randomized, placebo-controlled, open-label clinical trial to assess for any effects of using mouthwash on the salivary SARS-CoV-2 viral load among asymptomatic to mildly symptomatic adult COVID-19-positive patients. Patients were randomized to receive either 20 mL of 0.05% CPC, 10 mL of 0.01% on-demand aqueous chlorine dioxide, or 20 mL of placebo mouthwash (purified water) in a 1:1:1 ratio. The primary endpoint was the cycle threshold (Ct) values employed for SARS-CoV-2 salivary viral load estimation. We used linear mixed-effects models to assess for any effect of the mouthwashes on SARS-CoV-2 salivary viral load.

resultsOf a total of 96 eligible participants enrolled from November 7, 2022, to January 19, 2023, 90 were accepted for the primary analysis. The use of 0.05% CPC mouthwash was not shown to be superior to placebo in change from baseline salivary Ct value at 30 min (difference vs. placebo, 0.640; 95% confidence interval [CI], -1.425 to 2.706; P = 0.543); 2 h (difference vs. placebo, 1.158; 95% CI, -0.797 to 3.112; P = 0.246); 4 h (difference vs. placebo, 1.283; 95% CI, -0.719 to 3.285; P = 0.209); 10 h (difference vs. placebo, 0.304; 95% CI, -1.777 to 2.385; P = 0.775); or 24 h (difference vs. placebo, 0.782; 95% CI, -1.195 to 2.759; P = 0.438). The use of 0.01% on-demand aqueous chlorine dioxide mouthwash was also not shown to be superior to placebo in change from baseline salivary Ct value at 30 min (difference vs. placebo, 0.905; 95% CI, -1.079 to 2.888; P = 0.371); 2 h (difference vs. placebo, 0.709; 95% CI, -1.275 to 2.693; P = 0.483); 4 h (difference vs. placebo, 0.220; 95% CI, -1.787 to 2.226; P = 0.830); 10 h (difference vs. placebo, 0.198; 95% CI, -1.901 to 2.296; P = 0.854); or 24 h (difference vs. placebo, 0.784; 95% CI, -1.236 to 2.804; P = 0.447).

conclusionsIn asymptomatic to mildly symptomatic adults with COVID-19, compared to placebo, the use of 0.05% CPC and 0.01% on-demand aqueous chlorine dioxide mouthwash did not lead to a significant reduction in SARS-CoV-2 salivary viral load. Future studies of the efficacy of CPC and on-demand aqueous chlorine dioxide mouthwash on the viral viability of SARS-CoV-2 should be conducted using different specimen types and in multiple populations and settings.

Indexed as

CetylpyridiniumCOVID-19MouthwashesSalivaViral LoadAdultAgedChlorine CompoundsFemaleHumansMaleMiddle AgedOxidesSARS-CoV-2CetylpyridiniumChlorine Compoundschlorine dioxideMouthwashesOxidesCetylpyridinium chlorideCOVID-19MouthwashOn-demand aqueous chlorine dioxide solutionRandomized clinical trial

Identifiers

PMID38664718
PMCPMC11044332
OpenAlexW4395456627

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.