was read the article
array:24 [ "pii" => "S180759322200446X" "issn" => "18075932" "doi" => "10.6061/clinics/2020/e2328" "estado" => "S300" "fechaPublicacion" => "2020-01-01" "aid" => "446" "copyright" => "CLINICS" "copyrightAnyo" => "2020" "documento" => "article" "crossmark" => 0 "licencia" => "https://creativecommons.org/licenses/by/4.0/" "subdocumento" => "dis" "cita" => "Clinics. 2020;75C:" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "itemSiguiente" => array:19 [ "pii" => "S1807593222004471" "issn" => "18075932" "doi" => "10.6061/clinics/2020/e2338" "estado" => "S300" "fechaPublicacion" => "2020-01-01" "aid" => "447" "copyright" => "CLINICS" "documento" => "article" "crossmark" => 0 "licencia" => "https://creativecommons.org/licenses/by/4.0/" "subdocumento" => "dis" "cita" => "Clinics. 2020;75C:" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:8 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">COMMENTS</span>" "titulo" => "Comments on “Evaluation of the Accuracy of Mammography, Ultrasound and Magnetic Resonance Imaging in Suspect Breast Lesions”" "tienePdf" => "en" "tieneTextoCompleto" => "en" "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Yongyu An" "autores" => array:1 [ 0 => array:2 [ "nombre" => "Yongyu" "apellidos" => "An" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1807593222004471?idApp=UINPBA00004N" "url" => "/18075932/000000750000000C/v1_202211290815/S1807593222004471/v1_202211290815/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1807593222004458" "issn" => "18075932" "doi" => "10.6061/clinics/2020/e2298" "estado" => "S300" "fechaPublicacion" => "2020-01-01" "aid" => "445" "copyright" => "CLINICS" "documento" => "article" "crossmark" => 0 "licencia" => "https://creativecommons.org/licenses/by/4.0/" "subdocumento" => "fla" "cita" => "Clinics. 2020;75C:" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">ORIGINAL ARTICLE</span>" "titulo" => "Impact of COVID-19 pandemic on a daily-based outpatient treatment routine: experience of a radiotherapy department of a tertiary public/university hospital in Brazil" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => "en" "contieneResumen" => array:1 [ "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig3" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 901 "Ancho" => 1503 "Tamanyo" => 117390 ] ] "descripcion" => array:1 [ "en" => "<p id="spara30" class="elsevierStyleSimplePara elsevierViewall">Comparison between April and May 2019 and April and May 2020 by diagnosis of treated patients. Legend: Uro = urological cancers (most prostate); GI = gastrointestinal cancers; CNS = Central nervous system tumors; Hemato = hematological cancers; Gyn = gynecological cancers.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Heloisa de Andrade Carvalho, Karina Gondim Moutinho C. Vasconcelos, Herbeni Cardoso Gomes, João Víctor Salvajoli" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Heloisa" "apellidos" => "de Andrade Carvalho" ] 1 => array:2 [ "nombre" => "Karina Gondim Moutinho C." "apellidos" => "Vasconcelos" ] 2 => array:2 [ "nombre" => "Herbeni Cardoso" "apellidos" => "Gomes" ] 3 => array:2 [ "nombre" => "João Víctor" "apellidos" => "Salvajoli" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1807593222004458?idApp=UINPBA00004N" "url" => "/18075932/000000750000000C/v1_202211290815/S1807593222004458/v1_202211290815/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">COMMENTS</span>" "titulo" => "Potential mouth rinses and nasal sprays that reduce SARS-CoV-2 viral load: What we know so far?" "tieneTextoCompleto" => true "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Gabriel de Toledo Telles-Araujo, Raquel D'Aquino Garcia Caminha, Monira Samaan Kallás, Aytan Miranda Sipahi, Paulo Sérgio da Silva Santos" "autores" => array:5 [ 0 => array:3 [ "nombre" => "Gabriel" "apellidos" => "de Toledo Telles-Araujo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">I</span>" "identificador" => "aff1" ] ] ] 1 => array:3 [ "nombre" => "Raquel D'Aquino Garcia" "apellidos" => "Caminha" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">I</span>" "identificador" => "aff1" ] ] ] 2 => array:3 [ "nombre" => "Monira Samaan" "apellidos" => "Kallás" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">II</span>" "identificador" => "aff2" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">II</span>" "identificador" => "aff2a" ] ] ] 3 => array:3 [ "nombre" => "Aytan Miranda" "apellidos" => "Sipahi" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">III</span>" "identificador" => "aff3" ] ] ] 4 => array:4 [ "nombre" => "Paulo Sérgio" "apellidos" => "da Silva Santos" "email" => array:1 [ 0 => "paulosss@fob.usp.br" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">I</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor1" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Departamento de Cirurgia Estomatologia, Patologia e Radiologia, Escola de Odontologia de Bauru (FOB-USP), Universidade de Sao Paulo, Bauru, SP" "etiqueta" => "I" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Unidade de Tratamento Intensivo, Hospital Sirio Libanes, Sao Paulo, SP, BR" "etiqueta" => "II" "identificador" => "aff2" ] 2 => array:3 [ "entidad" => "Intensive Care Unit, Sírio Libanês Hospital, São Paulo, Brazil" "etiqueta" => "II" "identificador" => "aff2a" ] 3 => array:3 [ "entidad" => "Clinica e Laboratorio de Gastroenterologia Experimental (LIM07), Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR" "etiqueta" => "III" "identificador" => "aff3" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Corresponding author." ] ] ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig1" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 889 "Ancho" => 1503 "Tamanyo" => 90941 ] ] "descripcion" => array:1 [ "en" => "<p id="spara10" class="elsevierStyleSimplePara elsevierViewall">Flowchart of articles found in the PubMed/Medline, Cochrane, and the gray literature.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="para10" class="elsevierStylePara elsevierViewall">Dear editor:</p><p id="para20" class="elsevierStylePara elsevierViewall">In parallel with the efforts of the global scientific community toward investigating the pathophysiology, prevention, and treatment of coronavirus disease (COVID-19), all medical specialties that deal with frontline care have readapted their care protocols to better treat patients and protect their teams when fighting against the pandemic.</p><p id="para30" class="elsevierStylePara elsevierViewall">Concerning COVID-19 transmission, publications have focused on the premise that saliva plays a central role in the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and that procedures performed in oral and nasopharyngeal areas can generate a large number of droplets and aerosols. However, in the absence of vaccines or effective therapies, it is crucial to explore existing treatments to reduce the SARS-CoV-2 viral load. Infection control measures are still the only option for reducing the number of new infections (<a class="elsevierStyleCrossRef" href="#bib1">1</a>). These studies reinforce the importance of biosafety and cross-infection prevention protocols in limiting viral spread during these procedures (<a class="elsevierStyleCrossRefs" href="#bib2">2–4</a>).</p><p id="para40" class="elsevierStylePara elsevierViewall">On the basis of the few previously published studies that focused on understanding the potential effectiveness of antimicrobial solutions against COVID-19, in this study, we aimed to review publications on local control measures that contribute toward the reduction of SARS-CoV-2 viral load in patients with COVID-19, with the intent of making the host oral cavity and nasopharyngeal mucosa less contagious, controlling droplet transmission mainly to healthcare providers, and flattening the COVID-19 curve.</p><p id="para50" class="elsevierStylePara elsevierViewall">To assess the literature on the virucidal effect of antimicrobial solutions, a systematic review was carried out with an electronic search of the following databases: PubMed/Medline and Cochrane. To establish the search strategy, all studies had to address the following question: “What are the local measures to decrease the coronavirus viral load in the nasopharyngeal and oropharyngeal tracts?” A descripted search strategy was structured with Boolean operators (AND/OR/NOT) and the following keywords: (SARS-cov-2) OR (COVID-19) OR (coronavirus) AND (povidone-iodine) OR (chlorhexidine digluconate) OR (hydrogen peroxide) OR (oral rinse) OR (mouthwashes) OR (anti-infective agents) OR (PVP-I) OR (β-cyclodextrin) OR (Citrox) AND (saliva) OR (nasal cavity) OR (mouth) OR (oral cavity) OR (throat) OR (nasopharyngeal) OR (oropharyngeal). The search included published articles until August 10, 2020. In addition, the gray literature was also reviewed, including papers that eventually met the eligibility criteria upon discussion.</p><p id="para60" class="elsevierStylePara elsevierViewall">This systematic review was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (<a class="elsevierStyleCrossRef" href="#bib5">5</a>). All studies met the criteria established by the Patient, Intervention, Comparison, and Outcome strategy, as follows: participants (P), patients with COVID-19; intervention (I), solutions with virucidal activity; control (C), patients not using antimicrobial solutions; and outcome (O), the reduction of salivary SARS-CoV-2 viral load.</p><p id="para70" class="elsevierStylePara elsevierViewall">The inclusion criteria were as follows: 1) <span class="elsevierStyleItalic">in vitro</span>, <span class="elsevierStyleItalic">in vivo</span>, and randomized clinical trials that addressed the use of mouthwashes or nasal sprays to reduce the viral load of SARS-CoV-2, 2) unlimited study period, and 3) having no language restriction. The exclusion criteria were as follows: 1) case reports and 2) systematic reviews.</p><p id="para80" class="elsevierStylePara elsevierViewall">Overall, 75 articles were identified in the selected databases: 65 studies in PubMed/Medline, eight in Cochrane, and two in the gray literature. The final sample included 11 papers that fulfilled all of the above-mentioned inclusion and exclusion criteria (<a class="elsevierStyleCrossRef" href="#fig1">Figure 1</a>).</p><elsevierMultimedia ident="fig1"></elsevierMultimedia><p id="para90" class="elsevierStylePara elsevierViewall">The data and outcomes obtained from these selected articles are listed in <a class="elsevierStyleCrossRef" href="#tbl1">Table 1</a>.</p><elsevierMultimedia ident="tbl1"></elsevierMultimedia><p id="para100" class="elsevierStylePara elsevierViewall">In healthcare settings, including hospital intensive care units (ICU) and dental offices, COVID-19 transmission because of the overabundance of SARS-CoV-2 in droplets of saliva released as aerosols is not traceable to an index patient because the particles remain airborne for some time and then settle over horizontal surfaces in rooms/offices (<a class="elsevierStyleCrossRefs" href="#bib13">13–15</a>). As there are no drugs or vaccines for COVID-19 available yet, local infection control measures are the only available alternatives to slow viral transmission/infection.</p><p id="para110" class="elsevierStylePara elsevierViewall">The Guideline for the Diagnosis and Treatment of Novel Coronavirus Pneumonia (the 5th edition) (<a class="elsevierStyleCrossRef" href="#bib16">16</a>), released by the National Health Commission of the People's Republic of China, concluded that chlorhexidine may not be effective in eliminating SARS-CoV-2. In addition, an <span class="elsevierStyleItalic">in vitro</span> study also revealed the inefficacy of chlorhexidine digluconate in killing human coronaviruses, such as those causing SARS and Middle East Respiratory Syndrome and the endemic human coronavirus (<a class="elsevierStyleCrossRef" href="#bib17">17</a>).</p><p id="para120" class="elsevierStylePara elsevierViewall">However, a recently published study that evaluated SARS-CoV-2 dynamics in various body fluid specimens, such as saliva, oropharyngeal swabs, and nasopharyngeal swabs, concluded that viral load in the saliva can transiently be decreased for 2 h after using chlorhexidine mouthwash in COVID-19 patients (<a class="elsevierStyleCrossRef" href="#bib18">18</a>). However, to better understand the effectiveness of chlorhexidine in decreasing the viral load, randomized controlled trials with a greater number of patients are still necessary.</p><p id="para130" class="elsevierStylePara elsevierViewall">On the basis of the outcomes of this review, we strongly recommend the use of povidone-iodine (PVP-I) as a pre-procedure mouth rinse and nasal spray to reduce the SARS-CoV-2 viral load in oral aerosols (<a class="elsevierStyleCrossRef" href="#bib19">19</a>). In our opinion, PVP-I could be considered an adjunct to personal protective equipment during this pandemic. PVP-I is a simple, affordable, and practically innocuous intervention that has shown promising virucidal results in a few <span class="elsevierStyleItalic">in vitro</span> studies and in the first <span class="elsevierStyleItalic">in vivo</span> study. Its use at the lowest concentration (0.5%) and for the lowest contact time (15 s) led to the complete inactivation of SARS-CoV-2. Hence, it is indicated for patients and healthcare workers.</p><p id="para140" class="elsevierStylePara elsevierViewall">Although PVP-I showed better virucidal activity than that of hydrogen peroxide, we elucidated the fact that most of the studies were performed in an <span class="elsevierStyleItalic">in vitro</span> scenario, which does not take into account the impact of host immunity when using the solution (where the response to the agent would be different).</p><p id="para150" class="elsevierStylePara elsevierViewall">Although aerosols are not the major source of SARS-CoV-2 transmission, they are considered a potential risk of contamination among frontline workers. We are aware that it is not possible to eliminate all risks in a healthcare setting. However, as the viral load of the mucosa in the oral cavity, throat, and nose is high and anatomically integrated, recontamination will occur soon after rinsing. Thus, the literature recommends applying PVP-I every 2-3 hours, up to four times per day, in those who have suspected or confirmed SARS-CoV-2 infection and are undergoing high-risk procedures that involve aerosol production, such as orotracheal intubation, beyond the oral care administered in an ICU to patients under mechanical ventilation (<a class="elsevierStyleCrossRef" href="#bib20">20</a>).</p><p id="para160" class="elsevierStylePara elsevierViewall">To date, the substances that have been suggested to potentially reduce the viral load in COVID-19 patients in the studies that we reviewed are primarily PVP-I, followed by hydrogen peroxide and chlorhexidine. We do not recommend the use of cyclodextrin combined with Citrox, as there is no evidence in the literature regarding its real impact on the SARS-CoV-2 viral load. Four randomized clinical trials are underway, which may help better formulate guidelines and strategies to minimize COVID-19 transmission.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:1 [ "nota" => "<p class="elsevierStyleNotepara" id="cenpara10">No potential conflict of interest was reported.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig1" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 889 "Ancho" => 1503 "Tamanyo" => 90941 ] ] "descripcion" => array:1 [ "en" => "<p id="spara10" class="elsevierStyleSimplePara elsevierViewall">Flowchart of articles found in the PubMed/Medline, Cochrane, and the gray literature.</p>" ] ] 1 => array:7 [ "identificador" => "tbl1" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="TFN01t01" class="elsevierStyleSimplePara elsevierViewall">LEGEND: NA=not applicable; Citrox=combination of natural bioflavonoids extracted from citrus fruits; βCD=β-cyclodextrins; NR=not reported; PVP-I=povidone-iodine; H<span class="elsevierStyleInf">2</span>O<span class="elsevierStyleInf">2</span>=hydrogen peroxide.</p>" "tablatextoimagen" => array:1 [ 0 => array:1 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Authors, Year (Country) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Type of Publication Study \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Sample (N) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Antimicrobial Solutions (Mouth rinse/Nasal spray) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Conclusions \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Carrouel et al., 2020 [6] (France, Italy, Brazil, Spain) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Editorial (Multicenter) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1. Citrox    2. Amphiphilic βCD    3. Cyclodextrins+Citrox \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1. Citrox may reduce viral load    2. Amphiphilic βCD reduces viral load in oral cavity and nasal applications; hence, it may be considered in preventing viral transmission via the oropharyngeal route.    3. Clinical trials are still necessary to evaluate the benefits of βCD+Citrox in reducing the viral load of SARS-CoV-2. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Yoon et al., 2020 [7] (South Korea) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Clinical trial \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 patients \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Chlorhexidine \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Chlorhexidine mouthwash was effective in reducing the SARS-CoV-2 viral load in the saliva transiently (2 h). \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Anderson et al., 2020 [8] (Singapore) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">In vitro</span> study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PVP-I \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Antiseptic solution (PVP-I 10%), skin cleanser (PVP-I 7.5%), gargle and mouth wash (PVP-I 1%), and throat spray (PVP-I 0.45%) achieved ≥    99.99% virucidal activity against SARS-CoV-2 within 30 s. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Bidra et al., 2020 [9] (USA) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">In vitro</span> study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PVP-I oral rinse (0.5%, 1.25%, and 1.5%)    H<span class="elsevierStyleInf">2</span>O<span class="elsevierStyleInf">2</span> aqueous solutions (3% and 1.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PVP-I oral antiseptic rinse at all three concentrations completely inactivated SARS-CoV-2.    H<span class="elsevierStyleInf">2</span>O<span class="elsevierStyleInf">2</span> solutions at concentrations of 1.5% and 3.0% showed minimal virucidal activity after 15 s and 30 s of contact time. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Bidra et al., 2020 [10] (USA) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">In vitro</span> study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PVP-I oral rinse (0.5%, 1.25%, and 1.5%)    Positive control - Ethanol (70%)    Negative control - Water \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PVP-I oral antiseptics, at all tested concentrations, completely inactivated SARS-CoV-2 within 15 s of contact.    Ethanol 70% was only able to inactivate the virus at 30 s of contact. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Lamas et al., 2020 [11] (Spain) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">In vivo</span> study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 patients \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PVP-I (1%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">In two of the four patients, PVP-I resulted in a significant drop in viral load, which remained for at least 3 h. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Liang et al., 2020 [12] (China, USA) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">In vitro</span> study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PVP-I eye drop (gel forming) PVP-I nasal spray (gel forming) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Dose- and time-dependent inactivation of SARS-CoV-2 was observed in both the cases. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NCT04410159 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Clinical Trial \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Povidone-iodine <span class="elsevierStyleItalic">versus</span> essential oil <span class="elsevierStyleItalic">versus</span> tap-water gargling for COVID-19 patients \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NR \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NCT04409873 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Clinical Trial \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Antiseptic mouthwash/pre-procedural rinse on SARS-CoV-2 load (COVID-19) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NR \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NCT04449965 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Clinical Trial \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">60 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Betadine sinonasal rinses, Betadine mouth gargle, and 6% PVP‐I gel forming nasal spray \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NR \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NCT04347954 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Clinical Trial \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PVP-I nasal sprays and SARS-CoV-2 nasopharyngeal titers (for COVID-19) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NR \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spara20" class="elsevierStyleSimplePara elsevierViewall">Mouth rinses or nasal sprays to reduce SARS-CoV-2 viral load.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => 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Brasil (CAPES) - Finance Code 001.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/18075932/000000750000000C/v1_202211290815/S180759322200446X/v1_202211290815/en/main.assets" "Apartado" => null "PDF" => "https://static.elsevier.es/multimedia/18075932/000000750000000C/v1_202211290815/S180759322200446X/v1_202211290815/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S180759322200446X?idApp=UINPBA00004N" ]
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2024 July | 30 | 15 | 45 |
2024 June | 38 | 19 | 57 |
2024 May | 46 | 13 | 59 |
2024 April | 26 | 12 | 38 |
2024 March | 50 | 16 | 66 |
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2023 August | 32 | 9 | 41 |
2023 July | 24 | 24 | 48 |
2023 June | 40 | 19 | 59 |
2023 May | 20 | 3 | 23 |
2023 April | 18 | 1 | 19 |
2023 March | 21 | 2 | 23 |
2023 February | 2 | 1 | 3 |
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2022 November | 3 | 0 | 3 |