Evidence map›Paper›PMID 39268910›Full record

SynthesisThe Laryngoscope2025

Washing Illness Away: A Systematic Review of the Impact of Nasal Irrigation and Spray on COVID-19.

Karan Gandhi, Freeman Paczkowski, Leigh Sowerby

Erratum issuedAbstract readSystematic Review
In one paragraph

Synthesis in The Laryngoscope, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors.

Karan GandhiDepartment of Otolaryngology-Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.ORCID 0000-0003-4159-8670
Freeman PaczkowskiSchulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.ORCID 0009-0001-5580-6920
Leigh SowerbyDepartment of Otolaryngology-Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.ORCID 0000-0002-5825-2759

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveNasal irrigation is a common treatment for sinonasal disorders; however, it is unknown if it can reduce SARS-CoV-2 nasopharyngeal viral load (NVL). This systematic review investigated the efficacy of nasal irrigation with saline, povidone iodine (PVP-I), and intranasal corticosteroids (INCS) at reducing SARS-CoV-2 NVL and transmissibility. DATA SOURCES: Databases including Embase, MEDLINE, Web of Science, and ClinicalTrials.gov. REVIEW

methodsA systematic review was completed with pre-defined search criteria using keywords related to nasal irrigation and COVID-19 from 1946 through January 2024. This review followed PRISMA reporting guidelines and was registered on PROSPERO. Only in-vivo studies testing nasal irrigation with either saline, PVP-I, or INCS for reducing NVL were included.

resultsNine out of ten studies on saline-based solutions reported positive effects in reducing NVL, with benefits noted in earlier time to negative nasopharyngeal PCR and a greater decline in NVL during early study time points, compared with controls. Isotonic and hypertonic saline mediums were found to be effective with three studies demonstrating enhanced efficacy with additives. Four out of seven studies on PVP-I showed a positive effect on reducing NVL, but results were heterogenous. Four studies demonstrated reduction of transmission with saline or PVP-I. No studies were found on INCS.

conclusionSaline nasal irrigation showed the best efficacy in reducing SARS-CoV-2 NVL. Additives to saline may have a clinical benefit, but further studies are needed to elucidate their isolated impacts on NVL. Data on PVP-I is inconclusive and further studies are warranted to determine the ideal concentration for irrigation. Laryngoscope, 135:517-528, 2025.

Indexed as

COVID-19Nasal LavageNasal SpraysPovidone-IodineAdministration, IntranasalAdrenal Cortex HormonesHumansNasopharynxSaline SolutionViral LoadAdrenal Cortex HormonesNasal SpraysPovidone-IodineSaline SolutionCOVID‐19INCSnasal saline irrigationPVP‐Iviral load

Identifiers

PMID39268910
PMCPMC11725691

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.