People who have tested positive for coronavirus infection may be able to avoid developing severe COVID-19 symptoms with a simple, safe, effective, and inexpensive technique they can perform at home, which involves rinsing their nasal cavity with a mild saline solution made by mixing half a teaspoon of salt and baking soda in a cup of boiled or distilled water. The mixture is then placed in a pot to irrigate the nose and applied twice a day.
As revealed by a new clinical trial conducted by researchers at the Medical College of Georgia (MCG) at Augusta University (USA), starting to do this as soon as SARS-CoV-2 infection is detected would help to reduce significant risk of hospital admission and death of patients.
“What we say in the ER and surgery is that the solution to contamination is dilution,” said Dr. Amy Baxter, an emergency medicine physician at the Medical College of Georgia at Augusta University and author of the study published in Ear, Nose & Throat Journal. “By providing additional hydration to the sinuses, it makes them function better. If you have a contaminant, the more you remove it, the better you can get rid of dirt and viruses and whatever else,” she adds.
“We found an 8.5-fold reduction in hospitalizations and no deaths compared to our controls,” said Dr. Richard Schwartz, chairman of the Department of Emergency Medicine at MCG and lead author. “Both are pretty important endpoints.”
Prevent severe COVID with a home method
The researchers found that fewer than 1.3% of 79 study subjects age 55 and older who enrolled within 24 hours of testing positive for COVID-19 PCR between September 24 and September 21 December 2020, they were hospitalized, and none died. Among the participants, who were treated at MCG and the Augusta University (UA) Health System and followed for 28 days, one was admitted to the hospital and one went to the emergency room but was not admitted.
By comparison, 9.47% of patients were hospitalized and 1.5% died in a demographically similar group reported by the Centers for Disease Control and Prevention during the same period, which began about nine months later. after the coronavirus was first detected in the United States.
Nasal washing, “providing additional hydration to the sinuses makes them function better. If you have a contaminant, the more you remove it the better you can get rid of dirt or viruses like SARS-CoV-2”
“The reduction from 11% to 1.3% as of November 2021 would have corresponded in absolute terms to more than one million fewer older Americans requiring admission,” the authors have written. “If confirmed in other studies, the potential reduction in morbidity and mortality worldwide could be profound.”
Schwartz says that Baxter came up with the nasal wash idea early in the pandemic and was cool with it because it was cheap, easy to use and could help millions of people at a time when the UCHS Emergency Department UA had already started to see many patients infected with SARS-CoV-2.
They knew that the higher the viral load – the more virus there was in the body – the worse the prognosis, says Baxter. “One of our thoughts was: If we can knock out some of the virus within 24 hours of the positive test, then maybe we can reduce the severity of that whole trajectory,” he says, even lessen the likelihood that the virus can get into the lungs, where it was causing permanent damage, often fatal to many patients.
Furthermore, the SARS-CoV-2 spike protein is known to bind to the ACE2 receptor present throughout the body and especially in the nasal cavity, mouth and lungs. That is why scientists have searched for drugs that can block the ability of the coronavirus to bind to ACE2, and Baxter says nasal irrigation with saline helps reduce this binding. Saline appears to inhibit the virus’s ability to make two cuts in itself, called furin cleavage, so it may better fit an ACE2 receptor once it detects one.
Participants self-administered nasal irrigation using either povidone-iodine (an antiseptic) or baking soda, mixed with water that had the same concentration of salt normally found in the body. The researchers did not find any additional benefit from the additives and feel that saline alone was sufficient. “It’s the rinsing and the amount that really matters,” says Baxter.
They also wanted to find out the impact nasal irrigation had on the severity of symptoms, such as chills and loss of taste and smell, and found that 23 of the 29 participants who irrigated twice a day throughout follow-up experienced no symptoms or just one at the end of two weeks, compared with 14 of the 33 who were less consistent. In fact, those who completed nasal irrigation twice daily reported that their symptoms abated sooner, regardless of which of the two common antiseptics they added to the saline water.
Nasal irrigation to combat respiratory viruses
The researchers explained that it had already been shown that nasal irrigation or washing can also be effective in reducing the duration and severity of infection by a family of viruses that includes coronaviruses, responsible for the common cold, as well as viruses of the influenza. “SARS-CoV-2 infection was another perfect situation for it,” says Baxter.
Nasal irrigation has been used in Southeast Asia for millennia, and Baxter had noted that countries such as Laos, Vietnam and Thailand had lower death rates from COVID-19. “Those were places that he knew from having been there, where they use nasal irrigation as a normal part of hygiene, just like brushing their teeth,” he has noted. Before the COVID pandemic, a study revealed that regular nasal irrigation performed in Thailand can improve nasal congestion, decrease runny nose, relieve sinus pain or headache, and improve taste and smell. the quality of sleep.
Schwartz has stated that the simplicity and safety of the treatment led him to recommend nasal irrigation to patients who test positive early on, and the trial findings confirm the desirability of recommending nasal irrigation to virtually anyone who tests positive. “Many of the people who have been using this now for months have told me that their seasonal allergies are gone, that it really does make a big difference in any of the things that go through the nose that are bothersome.”
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