Cited by 44SARS-CoV-2 and COVID-19 ResearchInfection Control and VentilationCOVID-19 Clinical Research Studies

Nasal disinfection for the prevention and control of COVID-19: A scoping review on potential chemo-preventive agents

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Cegolon, L., Javanbakht, M., Mastrangelo, G.·2020·International Journal of Hygiene and Environmental Health

Abstract

Background Neither pre-exposure nor post-exposure chemo-prophylaxis agents are currently available to prevent COVID-19. On the other hand, high loads of SARS-CoV-2 are shed from the nasal cavity before and after symptoms onset.Objective To conduct a scoping review on the available evidence on tolerable nasal disinfectants with encouraging health outcomes against SARS-CoV-2, i.e., agents effective against at least two different viruses beyond SARS-CoV-2.Methods Online databases were searched to identify papers published during 2010-2020. Publications were selected if they were relevant to the scoping review. The review was narrative, describing for each treatment the mechanism(s) of action, tolerability, in vitro and in vivo evidence of the effects against SARS-CoV-2 and whether the product had been marketed.Results Eight treatments were scrutinized: hypothiocyanite, lactoferrin, N-chlorotaurine, interferon-alpha, povidone-iodine, quaternary ammonium compounds, alcohol-based nasal antiseptics and hydroxychloroquine. In vitro viricidal effect against SARS-CoV-2 was reported for ethanol, alcohol-based hand sanitizers and povidone-iodine. Inhibition of other coronaviruses was described for lactoferrin, ethanol, hydroxychloroquine and quaternary ammonium compound. No treatment has been tested against SARS-CoV-2 in randomized controlled clinical trials thus far. However, interferon-alpha, lactoferrin and hydroxychloroquine were tested in one-arm open label uncontrolled clinical trial. Oxidant activity (hypothiocyanite, N-chlorotaurine and povidone-iodine), enhancement of endocytic and lysosomal pH (quaternary ammonium compounds and hydroxychloroquine) and destruction of the viral capsid (quaternary ammonium compounds, alcohol-based nasal antiseptics) were the main mechanisms of action. Lactoferrin and interferon-alpha have subtle biological mechanisms. With the exception of N-chlorotaurine, all other products available on the market.Conclusions Effective and safe chemo-prophylactic drugs against SARS-CoV-2 do not exist yet but most eligible candidates are already in the market. Whilst the human nasal cavity is the port of entry for SARS-CoV-2, the mouth is involved as exit site through emission of respiratory droplets. The well-known hand-to-nose-to-hand cycle of contamination requires appropriate additional strategies for infection control. To narrow down the subsequent laboratory and clinical investigations, a case-control approach could be employed to compare the use of candidate drugs among individuals testing positive and negative to COVID-19 swabs.

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  • The lack of the LPO/H2O2/SCN− pathway in nasal and ocular human secretions may explain the survival, proliferation, and environmental dissemination of some bacteria and viruses.

    “Several studies maintain that the lack of the LPO/H2O2/SCN− pathway in nasal and ocular human secretions may explain the survival, proliferation, and environmental dissemination of some bacteria and viruses [173].”

    From The Role of Reactive Species on Innate Immunity (2022) · cites this paper as [173]

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  1. Couch R.B. Medical Microbiology 1995 University of Texas Medical Branch Galveston 1 22 21413252
  2. Shintake T. Possibility of Disinfection of SARS-CoV-2 (COVID-19) in Human Respiratory Tract by Controlled Ethanol Vapor Inhalation. ArXiv - Cornell University Available from: https://arxiv.org/abs/2003.12444 · arXiv

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Authors
Cegolon, L., Javanbakht, M., & Mastrangelo, G.
Affiliations
  • IRCCS Materno Infantile Burlo Garofolo (IT)
  • Baqiyatallah University of Medical Sciences (IR)
  • University of Padua (IT)
Corresponding author
Cegolon, L.
Venue
International Journal of Hygiene and Environmental Health
Publisher
Elsevier BV
Published
2020-09
Volume
230
Pages
113605
ISSN
1438-4639 (ISSN-L)
OpenAlex
W3049433730
Cited by
44
References
87
Citations by year
2026: 1 · 2025: 2 · 2024: 4 · 2023: 8 · 2022: 16 · 2021: 9 · 2020: 4
FWCI
0.44
Type
journal article
Language
en
Open access
Locations
  • International Journal of Hygiene and Environmental Health (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • ArTS Archivio della ricerca di Trieste (University of Trieste https://www.units.it/) (submittedVersion, cc-by-nc-nd)
Topics
  • Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Infection Control and Ventilation
  • Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
Keywords
COVID-19 pandemic, SARS-CoV-2, chemoprevention, povidone-iodine, quaternary ammonium compounds, hydroxychloroquine, lactoferrin, interferon-alpha, hypothiocyanite, N-chlorotaurine, alcohol-based hand rub, virucidal activity, endocytosis, lysosomal pH, nasal cavity
MeSH terms
COVID-19, SARS-CoV-2, Disinfection, Humans, Hydroxychloroquine, Infection Control

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