Brief report
Utility of mouth rinses with povidone-iodine and hydrogen peroxide in patients with COVID-19
Utilidad de los enjuagues con povidona yodada y peróxido de hidrógeno en pacientes con COVID-19
Daniel Pablo-Marcosa, Beatriz Abascalb, Lara Lloretc, Manuel Gutiérrez Cuadrab, Nieves Velascod, Carmen Valerob,
Corresponding author
a Servicio de Microbiología, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, IDIVAL, Santander, Spain
b Departamento de Medicina Interna, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, IDIVAL, Santander, Spain
c Instituto de Física de Cantabria, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, IDIVAL, Santander, Spain
d Servicio de Farmacia Hospitalaria, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, IDIVAL, Santander, Spain
Read
518
Timeswas read the article
79
Total PDF
439
Total HTML
Share statistics
array:24 [ "pii" => "S2529993X2200171X" "issn" => "2529993X" "doi" => "10.1016/j.eimce.2022.08.003" "estado" => "S300" "fechaPublicacion" => "2023-03-01" "aid" => "2498" "copyright" => "Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica" "copyrightAnyo" => "2021" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Enferm Infecc Microbiol Clin. 2023;41:173-5" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0213005X21002950" "issn" => "0213005X" "doi" => "10.1016/j.eimc.2021.10.005" "estado" => "S300" "fechaPublicacion" => "2023-03-01" "aid" => "2498" "copyright" => "Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Enferm Infecc Microbiol Clin. 2023;41:173-5" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original breve</span>" "titulo" => "Utilidad de los enjuagues con povidona yodada y peróxido de hidrógeno en pacientes con COVID-19" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "173" "paginaFinal" => "175" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Utility of mouth rinses with povidone-iodine and hydrogen peroxide in patients with COVID-19" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1083 "Ancho" => 1508 "Tamanyo" => 80771 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Porcentaje de pacientes con PCR negativa en los 3 grupos.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Daniel Pablo-Marcos, Beatriz Abascal, Lara Lloret, Manuel Gutiérrez Cuadra, Nieves Velasco, Carmen Valero" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Daniel" "apellidos" => "Pablo-Marcos" ] 1 => array:2 [ "nombre" => "Beatriz" "apellidos" => "Abascal" ] 2 => array:2 [ "nombre" => "Lara" "apellidos" => "Lloret" ] 3 => array:2 [ "nombre" => "Manuel" "apellidos" => "Gutiérrez Cuadra" ] 4 => array:2 [ "nombre" => "Nieves" "apellidos" => "Velasco" ] 5 => array:2 [ "nombre" => "Carmen" "apellidos" => "Valero" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2529993X2200171X" "doi" => "10.1016/j.eimce.2022.08.003" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529993X2200171X?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213005X21002950?idApp=UINPBA00004N" "url" => "/0213005X/0000004100000003/v2_202303241054/S0213005X21002950/v2_202303241054/es/main.assets" ] ] "itemSiguiente" => array:18 [ "pii" => "S2529993X23000631" "issn" => "2529993X" "doi" => "10.1016/j.eimce.2021.08.018" "estado" => "S300" "fechaPublicacion" => "2023-03-01" "aid" => "2487" "copyright" => "Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Enferm Infecc Microbiol Clin. 2023;41:176-80" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Evaluation of the EUROIMMUN <span class="elsevierStyleItalic">Aspergillus</span> antigen immunoenzyme assay in serum and bronchoalveolar lavage fluid samples" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "176" "paginaFinal" => "180" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Evaluación del EUROIMMUN <span class="elsevierStyleItalic">Aspergillus</span> antigen immunoenzyme assay en muestras de suero y lavado broncoalveolar" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "María Pía Roiz-Mesones, Ana de Malet Pintos-Fonseca, Noelia Ahedo-García, Carlos Ruiz de Alegría-Puig" "autores" => array:4 [ 0 => array:2 [ "nombre" => "María Pía" "apellidos" => "Roiz-Mesones" ] 1 => array:2 [ "nombre" => "Ana de Malet" "apellidos" => "Pintos-Fonseca" ] 2 => array:2 [ "nombre" => "Noelia" "apellidos" => "Ahedo-García" ] 3 => array:2 [ "nombre" => "Carlos Ruiz de" "apellidos" => "Alegría-Puig" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529993X23000631?idApp=UINPBA00004N" "url" => "/2529993X/0000004100000003/v3_202311091248/S2529993X23000631/v3_202311091248/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S2529993X2300062X" "issn" => "2529993X" "doi" => "10.1016/j.eimce.2021.10.012" "estado" => "S300" "fechaPublicacion" => "2023-03-01" "aid" => "2504" "copyright" => "Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Enferm Infecc Microbiol Clin. 2023;41:169-72" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Outbreak of <span class="elsevierStyleItalic">Arcobacter butzleri</span>? An emerging enteropathogen" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "169" "paginaFinal" => "172" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Brote de <span class="elsevierStyleItalic">Arcobacter butzleri?</span> Un enteropatógeno emergente" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 779 "Ancho" => 2341 "Tamanyo" => 142959 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">PFGE dendogram of nine <span class="elsevierStyleItalic">A. butzleri</span> isolates and two control strains with their corresponding virulence genes. 10 pulsotypes were identified and the cluster #3 (red box) was identified in two isolates from the same patient.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Carlos Ruiz de Alegría Puig, Marta Fernández Martínez, Daniel Pablo Marcos, Jesús Agüero Balbín, Jorge Calvo Montes" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Carlos" "apellidos" => "Ruiz de Alegría Puig" ] 1 => array:2 [ "nombre" => "Marta" "apellidos" => "Fernández Martínez" ] 2 => array:2 [ "nombre" => "Daniel" "apellidos" => "Pablo Marcos" ] 3 => array:2 [ "nombre" => "Jesús" "apellidos" => "Agüero Balbín" ] 4 => array:2 [ "nombre" => "Jorge" "apellidos" => "Calvo Montes" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529993X2300062X?idApp=UINPBA00004N" "url" => "/2529993X/0000004100000003/v3_202311091248/S2529993X2300062X/v3_202311091248/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Brief report</span>" "titulo" => "Utility of mouth rinses with povidone-iodine and hydrogen peroxide in patients with COVID-19" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "173" "paginaFinal" => "175" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Daniel Pablo-Marcos, Beatriz Abascal, Lara Lloret, Manuel Gutiérrez Cuadra, Nieves Velasco, Carmen Valero" "autores" => array:6 [ 0 => array:3 [ "nombre" => "Daniel" "apellidos" => "Pablo-Marcos" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "Beatriz" "apellidos" => "Abascal" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Lara" "apellidos" => "Lloret" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "Manuel" "apellidos" => "Gutiérrez Cuadra" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 4 => array:3 [ "nombre" => "Nieves" "apellidos" => "Velasco" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] 5 => array:4 [ "nombre" => "Carmen" "apellidos" => "Valero" "email" => array:1 [ 0 => "mirvdc@humv.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Servicio de Microbiología, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, IDIVAL, Santander, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Departamento de Medicina Interna, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, IDIVAL, Santander, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Instituto de Física de Cantabria, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, IDIVAL, Santander, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Servicio de Farmacia Hospitalaria, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, IDIVAL, Santander, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Utilidad de los enjuagues con povidona yodada y peróxido de hidrógeno en pacientes con COVID-19" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1088 "Ancho" => 1513 "Tamanyo" => 80983 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Percentage of patients with negative PCR in the 3 groups.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The oral cavity plays an important role in the transmission of SARS-CoV-2<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a>. The oral mucosal epithelial cells express ACE-2 receptors and the salivary glands are a reservoir for the virus<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a>. For this reason, various scientific societies have proposed the use of antiseptic oral solutions to reduce transmission<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4,5</span></a>. Povidone-iodine (PVI) has already shown significant <span class="elsevierStyleItalic">in vitro</span> antiviral activity against MERS and SARS-CoV<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6,7</span></a> and more recently against SARS-CoV-2<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a>. Hydrogen peroxide (H<span class="elsevierStyleInf">2</span>O<span class="elsevierStyleInf">2</span>) is also effective against SARS-CoV-2 on inanimate surfaces<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> and in cell cultures<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a>. However, the <span class="elsevierStyleItalic">in vivo</span> efficacy of either oral antiseptic has not been clarified in this pandemic<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">11,12</span></a>. Therefore, we aim to determine the utility of mouth rinses and gargles with PVI and H<span class="elsevierStyleInf">2</span>O<span class="elsevierStyleInf">2</span> in reducing the oropharyngeal viral load of SARS-CoV-2 in patients with COVID-19.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and methods</span><p id="par0010" class="elsevierStylePara elsevierViewall">This was an observational prospective follow-up study (EPA-AS), classified by the Spanish Agency of Medicines and Medical Devices (AEMPS), in 88 patients (inpatients or outpatients) with COVID-19 confirmed by RT-PCR in nasopharyngeal samples (Ct <35 N or R gene; VIASURE SARS-CoV-2 Real Time PCR Detection Kit, Certest, Zaragoza, Spain). The patients were diagnosed at our hospital between May and November 2020. Patients under 18 years of age, patients with a decreased level of consciousness, presence of mouth ulcers or wounds, thyroid diseases, hypersensitivity to PVI or hydrogen peroxide, who were pregnant or breast-feeding or on treatment with lithium, were excluded. Inclusion in the study occurred less than 24<span class="elsevierStyleHsp" style=""></span>h after the first positive PCR determination. Of the 88 patients (mean age 43<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>17 years, range 19-86 years, 55% male), 31 carried out PVI (1%) oral solution rinses and gargles every 8<span class="elsevierStyleHsp" style=""></span>h (100<span class="elsevierStyleHsp" style=""></span>mg/ml; 30<span class="elsevierStyleHsp" style=""></span>s) for 2 consecutive days; 17 carried out rinses and gargles with H<span class="elsevierStyleInf">2</span>O<span class="elsevierStyleInf">2</span> (1.5%) with the same regimen and 40 were part of the control group without rinses or gargles. After the intervention, PCR was performed after 3 (2–4), 11 (9–13) and 17 (14–19) days in all patients.</p><p id="par0015" class="elsevierStylePara elsevierViewall">SARS-CoV-2 viral load was measured by quantitative PCR in all determinations (qRT-PCR; EDX SARS-CoV-2 Standard; Exact Diagnostics, Bio-Rad; E, N, ORF1a, RdRP and S genes). The viral load was expressed as Log10 of the mean of the viral loads of both genes (N and R) and Ct values. The processing of the samples and the interpretation of the results was a blinded study. Serological studies (IgG) were performed by chemiluminescence immunoassay (VirClia, Monotest, Vircell, S.L., Granada, Spain).</p><p id="par0020" class="elsevierStylePara elsevierViewall">Informed consent was requested and the study was approved by the Cantabrian Medicines Research Ethics Committee.</p><p id="par0025" class="elsevierStylePara elsevierViewall">The results were expressed as the mean and standard deviation (SD) for the quantitative variables and n (%) for the qualitative variables. The Kolmogorov–Smirnov test was used to determine the distribution of the variable. The Student’s T-test or Mann–Whitney U test was used for the comparison of quantitative variables and the Chi-squared or Fisher’s test was used for qualitative variables. The SPSS 23.0 software statistical package was used (Chicago, IL, USA). Statistical significance was considered to be p<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0030" class="elsevierStylePara elsevierViewall">Two thirds of the patients were seen on an outpatient basis (76%). The 3 groups began with the same viral load in the first positive PCR (PVI 6.4<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.0 copies/ml, H<span class="elsevierStyleInf">2</span>O<span class="elsevierStyleInf">2</span> 7.5<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.1 copies/ml and controls 6.8<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.2 copies/ml). There were no differences in viral load after rinses in the second determination (PVI 4.3<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.7 copies/ml, H<span class="elsevierStyleInf">2</span>O<span class="elsevierStyleInf">2</span> 4.6<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.9 copies/ml and controls 4.4<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>3.0 copies/ml). Neither were there differences in the third and fourth successive PCR determinations (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). The Ct values (N and R gene) were similar in the 3 groups at all times (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">The percentage of patients whose PCR was negative in the second determination was 27% in PVI, 23% in H<span class="elsevierStyleInf">2</span>O<span class="elsevierStyleInf">2</span> and 26% in controls. These percentages were similar in the third PCR (62%, 54%, and 58%) and fourth PCR (81%, 75%, and 81%, respectively) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">There were no differences in the immune response. 87% of the patients with PVI rinses developed immunoglobulin G, compared to 82% in H<span class="elsevierStyleInf">2</span>O<span class="elsevierStyleInf">2</span> and 95% in the controls (mean time of 74<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>31, 78<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>33 and 81<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>48 days, respectively).</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0045" class="elsevierStylePara elsevierViewall">PVI and H<span class="elsevierStyleInf">2</span>O<span class="elsevierStyleInf">2</span> rinses and gargles did not change the oropharyngeal viral load of patients with COVID-19. These oral antiseptics did not accelerate the negativisation of the PCR for SARS-CoV-2. PVI is an iodophor that owes its antiviral action to free iodine, altering cell membranes and protein synthesis<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a>. However, its recognised <span class="elsevierStyleItalic">in vitro</span> activity against SARS-CoV-2<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> does not seem to be evident <span class="elsevierStyleItalic">in vivo</span>, although we only found one clinical trial in this regard, conducted in 12 patients with COVID-19 who after receiving rinses and gargles with PVI (1%) did not have a modified oropharyngeal viral load of SARS-CoV-2 compared to the untreated group<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a>. Furthermore, H<span class="elsevierStyleInf">2</span>O<span class="elsevierStyleInf">2</span> has also shown efficacy <span class="elsevierStyleItalic">in vitro</span> in inactivating SARS-CoV-2, albeit less effectively than PVI<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a>. Its antiviral potency seems to be due to oxidation<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a>. To date, the use of this antiseptic in COVID-19 patients has been a matter of great debate<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">15,16</span></a>. Our work is the first observational study with a control group that evaluates the utility of H<span class="elsevierStyleInf">2</span>O<span class="elsevierStyleInf">2</span> mouth rinses in COVID-19 patients and we do not see a clear reduction in viral load in the short or in the medium term.</p><p id="par0050" class="elsevierStylePara elsevierViewall">We only found one other study, without a control group, in 12 hospitalised COVID-19 patients who received H<span class="elsevierStyleInf">2</span>O<span class="elsevierStyleInf">2</span> (1%) mouth rinses, with no change in their oropharyngeal viral load at 30<span class="elsevierStyleHsp" style=""></span>min<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a>.</p><p id="par0055" class="elsevierStylePara elsevierViewall">Our study has limitations, as it is not randomised. However, we included a large number of patients with a control group and evaluated the utility of two commonly used oral antiseptics.</p><p id="par0060" class="elsevierStylePara elsevierViewall">We conclude that rinses and gargles of PVI and H<span class="elsevierStyleInf">2</span>O<span class="elsevierStyleInf">2</span> do not seem to have a clear utility in reducing the oropharyngeal viral load of SARS-CoV-2. We believe that the recommendation for the use of these and other oral antiseptics should be based on scientific evidence, hence more studies are needed to assess their efficacy in this pandemic.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Funding</span><p id="par0065" class="elsevierStylePara elsevierViewall">This work was financed with a Research Grant awarded by the <span class="elsevierStyleGrantSponsor" id="gs0005">Consejo Superior de Investigaciones Científicas</span> [Spanish National Research Council] (CSIC. <span class="elsevierStyleGrantNumber" refid="gs0005">202050E106</span>). Spain.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conflicts of interest</span><p id="par0070" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:3 [ "identificador" => "xres2007040" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1719622" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres2007039" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1719621" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Materials and methods" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Funding" ] 9 => array:2 [ "identificador" => "sec0030" "titulo" => "Conflicts of interest" ] 10 => array:2 [ "identificador" => "xack701122" "titulo" => "Acknowledgements" ] 11 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2021-07-27" "fechaAceptado" => "2021-10-02" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1719622" "palabras" => array:5 [ 0 => "Mouth/rinses" 1 => "Povidone-iodine" 2 => "Coronavirus" 3 => "Hydrogen peroxide" 4 => "Load viral" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1719621" "palabras" => array:5 [ 0 => "Enjuagues orales" 1 => "Povidona yodada" 2 => "Coronavirus" 3 => "Peróxido de hidrógeno" 4 => "Carga viral" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Povidone-iodine and hydrogen peroxide could be effective in against SARS-CoV-2.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">A “non-interventional trial” in 88 patients (43<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>17 yrs., 55% men) with SARS-CoV-2 in nasopharyngeal swabs (RT-PCR). 31 received mouth rinses/gargling with povidone-iodine (every 8<span class="elsevierStyleHsp" style=""></span>h, two consecutive days), 17 with mouth rinses/gargling of hydrogen peroxide, and 40 controls. Were repeated PCR in 3, 11 and 17 days.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">After intervention the viral load (Log10 copies/ml) remained similar in povidone-iodine (4.3<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.7 copies/ml), hydrogen peroxide (4.6<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.9 copies/ml; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.40) and controls (4.4<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>3.0 copies/ml). The percentage of patients with a negative result in the second PCR was 27% in povidone-iodine group, 23% in hydrogen peroxide and 32% in controls; in the third PCR, 62%, 54% y 58% respectively; and in the fourth PCR, 81%, 75% y 81%.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Our results do not support the clinical usefulness of mouth rinses/gargling with povidone-iodine or hydrogen peroxide in patients with COVID-19.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducción</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">La povidona yodada y el peróxido de hidrógeno podrían ser eficaces contra el SARS-CoV-2.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Métodos</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional de seguimiento prospectivo (EPA-AS) en 88 pacientes (43<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>17 años, 55% varones) con SARS-CoV-2 en muestras nasofaríngeas (RT-PCR). 31 recibieron enjuagues/gargarismos con povidona yodada cada 8 horas dos días consecutivos, 17 con la misma pauta de peróxido de hidrógeno, y 40 controles sin enjuagues. Se repitió PCR a 3, 11 y 17 días.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Tras la intervención no hubo diferencias en la carga viral: povidona yodada (4,3<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2,7 copias/ml), peróxido de hidrógeno (4,6<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2,9 copias/ml; p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,40), controles (4,4<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>3,0 copias/ml). El porcentaje de pacientes con 2ª PCR negativa fue 27% povidona yodada, 23% peróxido de hidrógeno y 32% controles; en la 3ª PCR 62%, 54% y 58% respectivamente y en la 4ª PCR, 81%, 75% y 81%.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusión</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Nuestros resultados no apoyan la utilidad de los enjuagues de estos dos antisépticos en pacientes con COVID-19.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] ] "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1088 "Ancho" => 1513 "Tamanyo" => 80983 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Percentage of patients with negative PCR in the 3 groups.</p>" ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0020" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Mean (SD) or n (%).</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Ct: cycle threshold; RT-PCR: real-time polymerase chain reaction.</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Mann–Whitney: p (PVI and controls); p* (H<span class="elsevierStyleInf">2</span>O<span class="elsevierStyleInf">2</span> and controls).</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "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" style="border-bottom: 2px solid black"> \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" style="border-bottom: 2px solid black">Controls n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>40 \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" style="border-bottom: 2px solid black">PVI n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>31 \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" style="border-bottom: 2px solid black">H<span class="elsevierStyleInf">2</span>O<span class="elsevierStyleInf">2</span> n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>17 \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-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Log10 copies/ml</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Baseline PCR \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">6.8 (2.2) \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">6.4 (2.0); p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.38 \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">7.5 (2.1); p*<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.24 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2nd PCR \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">4.4 (3.0) \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">4.3 (2.7); p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.93 \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">4.6 (2.9); p*<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.84 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3rd PCR \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">2.4 (2.4) \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">1.7 (1.8); p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.40 \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">2.1 (2.5); p*<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.16 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4th PCR \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">1.1 (1.6) \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">1.0 (1.7); p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.91 \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">1.8 (2.5); p*<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.40 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Ct N gene</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Baseline PCR \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">26.8 (6.5) \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">27.7 (6.3); p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.62 \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">26.4 (6.2); p*<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.72 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2nd PCR \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">32.7 (7.4) \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">32.7 (7.0); p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.99 \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">33.1 (7.0); p*<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.70 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3rd PCR \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">37.6 (5.4) \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">39.7 (3.7); p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.27 \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">39.5 (5.4); p*<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.10 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4th PCR \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">40.3 (3.4) \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">40.3 (3.8); p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.96 \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">39.8 (5.6); p*<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.40 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Ct R gene</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Baseline PCR \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">26.3 (7.9) \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">27.0 (7.8); p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.68 \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">24.9 (7.8); p*<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.53 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2nd PCR \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">32.4 (8.4) \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">32.2 (7.6); p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.91 \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">33.5 (8.6); p*<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.45 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3rd PCR \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">38.0 (6.1) \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">39.6 (3.8); p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.88 \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">40.4 (5.5); p*<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.06 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4th PCR \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">41.3 (2.9) \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">40.5 (3.9); p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.33 \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">40.0 (5.8); p*<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.36 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3332964.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Viral load in the 3 groups.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:16 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Droplets and aerosols in the transmission of SARS-CoV-2" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M. Meselson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMc2009324" "Revista" => array:5 [ "tituloSerie" => "N Engl J Med" "fecha" => "2020" "volumen" => "382" "paginaInicial" => "2063" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32294374" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Community transmission of severe acute respiratory syndrome coronavirus 2, Shenzhen, China, 2020" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Liu" 1 => "X. Liao" 2 => "S. Qian" 3 => "J. Yuan" 4 => "F. Wang" 5 => "Y. Liu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3201/eid2606.200239" "Revista" => array:6 [ "tituloSerie" => "Emerg Infect Dis" "fecha" => "2020" "volumen" => "26" "paginaInicial" => "1320" "paginaFinal" => "1323" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32125269" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Oral saliva and COVID-19" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M. Baghizadeh Fini" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.oraloncology.2020.104821" "Revista" => array:3 [ "tituloSerie" => "Oral Oncol" "fecha" => "2020" "volumen" => "108" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prophylactic and therapeutic topical povidone-iodine in coronavirus disease 2019 (COVID-19): What is the evidence?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C.H. Yan" 1 => "B.S. Bleier" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/alr.22735" "Revista" => array:6 [ "tituloSerie" => "Int Forum Allergy Rhinol" "fecha" => "2020" "volumen" => "10" "paginaInicial" => "1271" "paginaFinal" => "1273" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33118690" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dental recommendations in the COVID-19 pandemic: a narrative review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J.P. Vargas-Buratovic" 1 => "F. Verdugo-Paiva" 2 => "C. Véliz-Paiva" 3 => "E. López-Tagle" 4 => "A. Ahumada-Salinas" 5 => "D. Ortuño-Borroto" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.5867/medwave.2020.05.7916" "Revista" => array:3 [ "tituloSerie" => "Medwave" "fecha" => "2020" "volumen" => "20" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Rapid and effective virucidal activity of povidone-iodine products against middle east respiratory syndrome coronavirus (MERS-CoV) and modified vaccinia virus ankara (MVA)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. Eggers" 1 => "M. Eickmann" 2 => "J. Zorn" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s40121-015-0091-9" "Revista" => array:6 [ "tituloSerie" => "Infect Dis Ther" "fecha" => "2015" "volumen" => "4" "paginaInicial" => "491" "paginaFinal" => "501" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26416214" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Inactivation of SARS coronavirus by means of povidone‐iodine, physical conditions, and chemical reagents" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "H. Kariwa" 1 => "N. Fujii" 2 => "I. Takashima" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Jpn J Vet Res" "fecha" => "2004" "volumen" => "52" "paginaInicial" => "105" "paginaFinal" => "112" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15631008" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Povidone-iodine demonstrates rapid in vitro virucidal activity against SARS-CoV-2, the virus causing COVID-19 disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D.E. Anderson" 1 => "V. Sivalingam" 2 => "A.E. Zheng Kang" 3 => "A. Ananthanarayanan" 4 => "H. Arumugam" 5 => "T.M. Jenkins" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s40121-020-00316-3" "Revista" => array:6 [ "tituloSerie" => "Infect Dis Ther" "fecha" => "2020" "volumen" => "9" "paginaInicial" => "669" "paginaFinal" => "675" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32643111" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "G. Kampf" 1 => "D. Todt" 2 => "S. Pfaender" 3 => "E. Steinmann" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jhin.2020.01.022" "Revista" => array:6 [ "tituloSerie" => "J Hosp Infect" "fecha" => "2020" "volumen" => "104" "paginaInicial" => "246" "paginaFinal" => "251" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32035997" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparison of in vitro inactivation of SARS CoV-2 with hydrogen peroxide and povidone-iodine oral antiseptic rinses" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A.S. Bidra" 1 => "J.S. Pelletier" 2 => "J.B. Westover" 3 => "S. Frank" 4 => "S.M. Brown" 5 => "B. Tessema" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/jopr.13220" "Revista" => array:6 [ "tituloSerie" => "J Prosthodont" "fecha" => "2020" "volumen" => "29" "paginaInicial" => "599" "paginaFinal" => "603" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32608097" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0055" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Povidone iodine mouthwash, gargle, and nasal spray to reduce nasopharyngeal viral load in patients with COVID-19: a randomized clinical trial" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "J. Guenezan" 1 => "M. Garcia" 2 => "D. Strasters" 3 => "C. Jousselin" 4 => "N. Lévêque" 5 => "D. Frasca" 6 => "O. Mimoz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/jamaoto.2020.5490" "Revista" => array:3 [ "tituloSerie" => "JAMA Otolaryngol Head Neck Surg" "fecha" => "2021" "volumen" => "4" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0060" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mechanisms of the action of povidone‐iodine against human and avian influenza A viruses: its effects on hemagglutination and sialidase activities" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "N. Sriwilaijaroen" 1 => "P. Wilairat" 2 => "H. Hiramatsu" 3 => "T. Takahashi" 4 => "T. Suzuki" 5 => "Y. Ito" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1743-422X-6-124" "Revista" => array:5 [ "tituloSerie" => "Virol J" "fecha" => "2009" "volumen" => "6" "paginaInicial" => "124" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19678928" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0065" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A prospective clinical pilot study on the effects of a hydrogen peroxide mouthrinse on the intraoral viral load of SARS-CoV-2" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Maximilian" 1 => "I.M. Gottsauner" 2 => "B. Schmidt" 3 => "K.J. Scholz" 4 => "W. Buchalla" 5 => "M. Widbiller" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00784-020-03549-1" "Revista" => array:6 [ "tituloSerie" => "Clin Oral Investig" "fecha" => "2020" "volumen" => "24" "paginaInicial" => "3707" "paginaFinal" => "3713" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32876748" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0070" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The role of oxidative stress in influenza virus infection" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Liu" 1 => "F. Chen" 2 => "T. Liu" 3 => "F. Chen" 4 => "S. Liu" 5 => "J. Yang" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.micinf.201708008" "Revista" => array:6 [ "tituloSerie" => "Microbes Infect" "fecha" => "2017" "volumen" => "19" "paginaInicial" => "580" "paginaFinal" => "586" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28918004" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0075" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hydrogen peroxide and viral infections: a literature review with research hypothesis definition in relation to the current covid-19 pandemic" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A.A. Caruso" 1 => "A. del Prete" 2 => "A.I. Lazzarino" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.mehy.2020.109910" "Revista" => array:3 [ "tituloSerie" => "Med Hypotheses" "fecha" => "2020" "volumen" => "144" ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0080" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Do hydrogen peroxide mouthwashes have a virucidal effect? A systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "K.L. Ortega" 1 => "B.O. Rech" 2 => "G.L.C. El Haje" 3 => "C.B. Gallo" 4 => "M. Pérez-Sayáns" 5 => "P.H. Braz-Silva" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jhin.2020.10.003" "Revista" => array:6 [ "tituloSerie" => "J Hosp Infect." "fecha" => "2020" "volumen" => "106" "paginaInicial" => "657" "paginaFinal" => "662" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33058941" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack701122" "titulo" => "Acknowledgements" "texto" => "<p id="par0075" class="elsevierStylePara elsevierViewall">To the Spanish National Research Council and Javier Xercavins, from the Ministry of Science and Innovation. To professors Jesús Agüero and J.A. Riancho (University of Cantabria), Spain.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/2529993X/0000004100000003/v3_202311091248/S2529993X2200171X/v3_202311091248/en/main.assets" "Apartado" => array:4 [ "identificador" => "66624" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Brief reports" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/2529993X/0000004100000003/v3_202311091248/S2529993X2200171X/v3_202311091248/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529993X2200171X?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 6 | 0 | 6 |
| 2024 October | 33 | 6 | 39 |
| 2024 September | 48 | 3 | 51 |
| 2024 August | 41 | 4 | 45 |
| 2024 July | 24 | 3 | 27 |
| 2024 June | 25 | 4 | 29 |
| 2024 May | 37 | 4 | 41 |
| 2024 April | 30 | 5 | 35 |
| 2024 March | 53 | 2 | 55 |
| 2024 February | 27 | 4 | 31 |
| 2024 January | 25 | 3 | 28 |
| 2023 December | 24 | 6 | 30 |
| 2023 November | 24 | 2 | 26 |
| 2023 October | 25 | 18 | 43 |
| 2023 September | 9 | 11 | 20 |
| 2023 August | 0 | 4 | 4 |
| 2023 March | 8 | 0 | 8 |
Show all
