Risk factors for severe COVID-19 symptoms include 65+ years of age, obesity, metabolic syndrome (i.e., diabetes, heart disease, stroke), and weakened immune systems (i.e., recovery from chemotherapy, HIV).1 In previous articles, I covered SARS-CoV-2 viral pathophysiology and micronutrient/lifestyle interventions which interfered with replication, oxidation/inflammation, and thrombosis. Although said nutrients are helpful upon contact of the virion within the cell, it is equally, if not more, imperative to consider interventions which inhibit cellular entry. As such, the following will consider the same in greater detail.

TRANSMISSION

SARS-CoV-2 primarily transmits via respiratory droplets from an infected individual’s mouth/nose.2 Although the virions migrate to several regions of the host (i.e., lungs, kidneys, cardiovascular system, digestive system, liver etc…), its first point of  contact with said host is through inhalation, where SARS-CoV-2 aggregates and replicates in the nasal and oral cavities.3 As such, it would be logical and prudent to implement interventions which interfaced with the virus before it entered, replicated, and spread to other organ systems.

IODINE-BASED NASAL AND ORAL WASHES

SARS-COV-2 Virion

Iodine is a molecule that can be found within a substance known as povidone iodine (PVP-1).2(42) PVP-1 is a substance known to have potent anti-bacterial, anti-fungal, anti-protozoan, and anti-viral properties.2(42) Research has also indicated its efficacy for inactivating (destroying) SARS-CoV-2; its mechanism of action via iodine (I2) destabilizes the SARS-CoV-2 membrane envelope (outer covering of the virus), the lipid bilayer within the envelope, and viral proteins to include RNA (the blueprint for replication)2(42) Ultimately, PVP-1 causes irreversible damage to the virus. Furthermore, PVP-1 behaves as an antioxidant scavenging free radicals (ionized molecules which damages cells) helping mitigate oxidation and inflammation.2(42)

** If there is difficulty accessing iodine-based nasal sprays (not readily available in many pharmacies, though oral equivalents are), nasal cleanses can include sprays which contain iota-carrageenan; a substance known to neutralize (binds to and inhibits cellular entry/replication) SARS-CoV-2, and the virus responsible for the common cold (i.e., rhinovirus).4,5

DOSING AND FREQUENCY

 

As little as 0.23%-1% iodine in solution (which can be purchased in oral and nasal washes; see pic above) has been found to reduce viral titers (viral concentrations) in nasal and oral swabs of infected individuals to non-detectable limits.2(42)Such was achievable by using a PVP-1 mouthwash between 30 seconds to 2 minutes, 3-4 times a day; said intervention remained effective for up to 3-4 hours in duration after each cleanse.2(42) When comparing PVP-1 to other solutions (i.e., alcohol, hydrogen peroxide) of differing concentrations (i.e., 0.5%, 1.25%, 1.5%), PVP-1 remained the most potent inactivator of SARS-CoV-2, even at 30 seconds of contact time.2(42) 

POTENTIAL SIDE EFFECTS

Chopra et al.2(43) noted that PVP-1 oral/nasal washes were well tolerated compared to other antiseptic agents; PVP-1 has been safely administered as much as 5 months nasally and 6 months orally. It should be noted, however, that miniscule amounts of I2 can be absorbed by mucosal cells of the nose/throat though thyroid function was not commonly affected.2(43) However, an excess of 6 months use has been correlated to increased thyroid stimulating hormone concentration, and should therefore be avoided amongst individuals with hyperthyroid/dysregulated thyroid and females who are pregnant/lactating.2(43) 

CONCLUSIONS

Risk factors for severe COVID-19 symptoms include 65+ years of age, obesity, metabolic syndrome, and weakened immune systems. Although SARS-CoV-2 viral oxidation/inflammation/replication/thrombosis management via micronutrient and lifestyle interventions is imperative, it is equally, if not more, prudent to consider interventions which help inhibit viral entry in the nasal/oral pathways. Considering the ease of use and safety of PVP-1, routine oral/nasal cleanses (as part of a larger protocol) could help control viral entry, replication, and severe downstream effects of SARS-CoV-2.

References

1. COVID-19: Who’s at Higher Risk of Serious Symptoms? Mayo Clinic. Updated October 30, 2021. Accessed December 21, 2021. https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/coronavirus-who-is-at-risk/art-20483301.
2. Chopra A, Sivaraman K, Radhakrishnan R, et al. Can povidone iodine gargle/mouthrinse inactivate SARS-CoV-2 and decrease the risk of nosocomial and community transmission during the COVID-19 pandemic? An evidence-based update. Jpn Dent Sci Rev. 2021;57:39-45. doi: 10.1016/j.jdsr.2021.03.001.
3. Trypsteen W, Van Cleemput J, Snippenberg Wv, et al. On the whereabouts of SARS-CoV-2 in the human body: A systematic review. PLoS Pathog. 2020;16(10):1-26. doi:https://doi.org/10.1371/journal. ppat.1009037.
4. Morokutti-Kurz M, Froba M, Graf P, et al. (2021) Iota-carrageenan neutralizes SARS-CoV-2 and inhibits viral replication in vitro. PLoS ONE. 2020;16(2):1-13. doi: https://doi.org/10.1371/journal. pone.0237480.
5. Bichiri D, Rente AR, Jesus A. Safety and efficacy of iota-carrageenan nasal spray in treatment and prevention of the common cold. Med Pharm Rep. 2021;94(1):28-34. doi: https://doi.org/10.1371/journal. pone.0237480.

 

-Michael McIsaac