Effect of phthalocyanine oral and nasal antiseptic solutions on the infectivity of SARS-CoV-2 in patients with COVID-19: a randomized controlled trial

Background

In individuals with coronavirus disease (COVID-19), the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load (VL) plays an important role in infectivity.

Objectives

This study aimed to evaluate the reduction in the VL and infectivity induced by phthalocyanine mouthwash and nasal spray in patients with COVID-19.

Methods

Patients with mild COVID-19 were recruited to participate in a triple-blinded randomized controlled trial. Participants were assigned to one of three groups: Group 1, non-active mouthwash and saline nasal spray (SNS); Group 2, phthalocyanine mouthwash and SNS; and Group 3 phthalocyanine mouthwash and phthalocyanine nasal spray. VL was assessed in nasopharyngeal and oropharyngeal swabs collected at the time of clinical diagnosis at baseline as well as 24 and 72 hours after starting the rinsing protocols.

Findings

Forty-six participants were included in the analysis: 15, 16, and 15 in Groups 1, 2, and 3, respectively. After 72 hours, the reduction in VL was significantly higher in Group 3 (mean cycle threshold (Ct) decrease: 11.21) than in Group 1 (mean Ct decrease: 5.53). Additionally, only the mean VL in Group 3 was reduced to a non-contagious level after 72 hours.

Main conclusions

Use of phthalocyanine mouthwash and nasal spray is effective at reducing SARS-CoV-2 infectivity.

Severe oral mucositis relating to pain and worse oral condition among patients with solid tumors undergoing treatment with FOLFIRI and 5-FU: a retrospective study

BACKGROUND

There is a need for studies that correlate the severity of oral mucositis (OM) with chemotherapy protocols, transient myelosuppression and oral health.

OBJECTIVE

To analyze the severity of OM among individuals with solid tumors during hospitalization and its correlation with the type of chemotherapy, myelosuppression and oral health condition.

DESIGN AND SETTING

Retrospective study at a public hospital in Bauru, state of São Paulo, Brazil, that is a regional referral center.

METHODS

Individuals diagnosed with solid malignant tumors who received chemotherapy during hospitalization for completion of the antineoplastic treatment cycle or who presented complications resulting from this were assessed.

RESULTS

Twenty-eight individuals (24.3%) manifested some degree of OM. The most prevalent degrees of OM according to the World Health Organization (WHO) and modified WHO classification were grades 2 (11.3%) and 5 (4.3%), respectively. It was observed that the higher the OM-WHO (P < 0.001; r = 0.306) and modified OM-WHO (P < 0.001; r = 0.295) classifications were, the greater the oral pain reported by the individuals was. Presence of mucositis in the upper lip and buccal mucosa contributed to increased severity of OM and worsening of swallowing during hospitalization. Thus, severe OM was associated with use of the FOLFIRI protocol (folinic acid, fluorouracil and irinotecan).

CONCLUSION

Individuals with tumors who presented severe OM had greater severity of oral pain and worse oral health. Use of the FOLFIRI protocol was associated with higher prevalence of severe OM, while use of 5-fluorouracil (5-FU) was correlated with worse oral condition.

Virucidal Activity of the Antiseptic Mouthwash and Dental Gel Containing Anionic Phthalocyanine Derivative: In vitro Study

AIM

This research suggested an in vitro virucidal action of a dental gel and a mouthwash with phthalocyanine derivative.

PURPOSE

The aim of this study was to report an in vitro study evaluating the virucidal capacity of mouthwash and dental gel containing anionic phthalocyanine derivate (APD).

METHODS

The research followed the recommendations of the National Health Surveillance Agency (ANVISA) and adapted methodology, described in the standards EN14776: 2015; ASTM E1053-11 and the Robert Koch Institute - RKI, in addition to good laboratory practices (GLP). The determination of the percentage of inactivation of the SARS-CoV-2 virus particles was carried out by imposing the viral solution in contact with the respective tested products, with intervals of 30 seconds, 1 and 5 minutes, with subsequent submission of the aliquots, recovered in cell culture microplates following virus titration using the TCID50 (50% Median Tissue Culture Infectious Dose).

RESULTS

The Mouthwash APD presented 90% of viral inactivation percentage, while the dental gel APD demonstrated 99.99% of viral inactivation.

CONCLUSION

In vitro analyses showed that mouthwash and dental gel APD can reduce the viability of SARS-CoV-2 virus particles.

Prevalência de Manifestações Bucais em Pacientes com Câncer Assistidos em um Programa de Atenção Domiciliar na Cidade de Pelotas-RS

Introdução: O município de Pelotas-RS dispõe do Programa de Internação Domiciliar Interdisciplinar (PIDI) implantado no Hospital Escola da Universidade Federal de Pelotas com a presença de cirurgiões-dentistas em sua equipe. O PIDI atende a pacientes oncológicos em cuidados paliativos. Objetivo: Avaliar a prevalência de manifestações bucais em pacientes assistidos por esse programa, as características epidemiológicas da referida população e verificar a associação das manifestações com o tipo de câncer e tratamento antineoplásico recebido. Método: Estudo transversal retrospectivo, com dados secundários coletados dos prontuários odontológicos de pacientes atendidos no período de abril de 2018 a setembro de 2019. O teste qui-quadrado foi aplicado com um nível de 5% de significância (p ≤0,05) atribuído aos resultados significativos. Resultados: As manifestações bucais foram encontradas 47 vezes nos 61 pacientes avaliados, sendo que alguns apresentaram mais de uma ocorrência. Pacientes que apresentavam câncer primário no sistema digestivo foram os mais acometidos por manifestações bucais. As mais prevalentes foram xerostomia (26,2%); candidíase (18%); mucosite (13,1%); disfagia e disgeusia, que apresentaram o mesmo percentual (9,8%); nenhum paciente desenvolveu carie de radiação. A xerostomia mostrou significância estatística (p≤0,05) na associação com o tipo de câncer. Ao correlacionar as manifestações bucais com o tipo de tratamento recebido, estas não apresentaram significância estatística. Conclusão: Este estudo demonstrou alta prevalência de manifestações bucais na população estudada, reafirmando a importância do cirurgião-dentista na equipe multiprofissional de cuidados paliativos.

A Phthalocyanine Derivate Mouthwash to Gargling/Rinsing as an Option to Reduce Clinical Symptoms of COVID-19: Case Series

Aim

This case series demonstrated that phthalocyanine derivate mouthwash is a promising alternative for reducing the viral load of SARS-CoV-2 and for clinical improvement of infected patients who presented mild and moderate symptoms.

Purpose

The aim of this study was to report a case series of patients diagnosed with COVID-19 that used the phthalocyanine derivate mouthwash to reduce clinical symptoms.

Patients and Methods

Eight patients used 5mL of phthalocyanine derivate mouthwash gargling/rinsing for one minute, five times daily, over a fourteen day period. Two measurement scales were applied for each patient in different periods to verify sore throat – VAS – Visual Analogue Scale for Pain and the clinical conditions – PS – Performance Status.

Results

All patients presented a significant reduction in clinical symptoms with the use of the mouthwash for gargling/rinsing after few days of use, without hospitalization.

Conclusion

The phthalocyanine derivate mouthwash protocol appears as a potential alternative for clinical improvement of COVID-19 infected patients. Daily use of this mouthwash rapidly reduced clinical symptoms such as sore throats, cough and mouth ulcers. Large, high-quality randomized controlled trials with larger sample size are necessary to confirm the effectiveness of this mouthwash protocol against COVID-19.