Benefit of Nasal Douche in COVID-19 Patients with Recurrence of Positive SARS-CoV-2 Viral RNA

Purpose

The purpose was to review relevant clinical data and formulate recommendations supporting the use of saline as a simple rinse for an early reassuring intervention to reduce the occurrence of re-positive COVID-19 patients.

Methods

We conducted a single-centre retrospective cohort study, which enrolled patients with confirmed re-testing positive COVID-19 during 7-60 days after discharge from Third People's Hospital of Shenzhen. By one-to-two propensity score matching for age and sex, the control group of those not re-testing positive during the same period served as matched control.

Results

A total of 223 patients were included in our study, 94 in re-positive group and 129 in non-re-positive group. The result shows that the rates of nasal douche treatment in the non-re-positive group were considerably higher than that of the re-positive group. And the Ct value of nasal douche group increased faster than that of non-nasal douche group after the Ct value reaching ≥35. Further analysis revealed that the higher the Ct value at the time of readmission, the shorter the time of average Ct values to reach ≥35.

Conclusion

These findings suggest that nasal douche is beneficial to shorten the time of virus nucleic acid turning negative, thereby reducing the incidence of re-positive. The prevention and control of epidemics focuses on re-positive patients with Ct values <35.

[Clinical study of hydrogen-rich saline in the treatment of moderate to severe allergic rhinitis]

Objective:To investigate the effectiveness and safety of nasal lavage with hydrogen-rich saline in the treatment of moderate to severe allergic rhinitis.Method:Twenty patients with moderate to severe persistent allergic rhinitis were treated with normal saline and hydrogen-rich saline lavage the nasal cavity. The study was randomized doubl-blind self-control study. The symptoms and signs score, treatment index and total effective rate were evaluated before and after treatment, and the nasal conjunctivitis related quality of life questionnaire (BQLQ) was used to evaluate the life quality of patients.Result:There were significant differences of the symptoms, signs scores, the treatment index, the total efficiency and BQLQ between the two kinds of lavage fluid used for patients before and after treatment(P<0.05). No significant adverse reactions occurred during follow-up.Conclusion:Hydrogen-enriched saline is safe and effective for allergic rhinitis.

Classification of non-allergic rhinitis based on inflammatory characteristics

The study aims to investigate nasal and lower airway inflammation in patients with non-allergic rhinitis (NAR), and to discuss a method of NAR classification based on inflammatory characteristics and its clinical significance. A total of 117 NAR patients admitted to our hospital from June 2010 to June 2011 were enrolled in this study, 162 healthy participants were employed as healthy controls. Nasal and lower airway inflammation were evaluated using the skin prick test, nasal and pulmonary visual analogue scale scoring, cell blood count, nasal douche, induced sputum assay, nasal provocation test, and bronchial provocation test. Compared to the healthy controls, NAR patients have significant higher levels of nasal douche eosinophils, more induced sputum eosinophils as well as blood eosinophils, and higher rates of nasal and bronchial provocation. Patient with high level of eosinophil in nasal douch tended to be with higher concentrations of eosinophils in induced sputum. Scores on the nasal and bronchial provocation tests are also correlated to each other. Among all NAR patients, 28 cases (23.9%) were with no abnormality detectable by eosinophil measurement or a provocation test, 39 cases (33.3%) were with elevated levels of eosinophils, and 50 cases (42.7%) exhibited a nasal provocation response. Based on this, all studied NAR cases were classified into 3 groups: non-specific type (group A, 28/117), increased eosinophil type (group B, 39/117), and hyper-reactive type (group C, 50/117). Some NAR cases may be considered as systemic inflammatory disease characterized by increased nasal eosinophil and nasal hyperreactivity.

Decreasing bacterial cross-contamination with a pulsating nasal irrigation device

BACKGROUND

The use of nasal irrigation in the management of postoperative endoscopic sinus surgery (ESS) patients is commonplace; however, the potential contamination of these bottles is concerning. The Sinugator® cordless pulsating nasal wash (NeilMed Pharmaceuticals, Inc., Santa Rosa, CA) is a battery-operated, positive pressure, pulsatile pump with a unidirectional flow. The principal aim of this study was to determine the incidence of cross-contamination using the pulsating nasal irrigation device and compare it with the traditional squeeze bottle.

METHODS

Eleven post-ESS patients were given a NeilMed Sinugator nasal wash to use 3 times per day. A sterile nasal swab was obtained at the initial and second postoperative visits. A swab of the plastic irrigation reservoir was collected at the second visit.

RESULTS

The overall contamination rate of bottles was found to be 45%. During the study several different organisms were cultured in the nose and bottles. The most commonly isolated organisms were coliforms and Staphylococcus aureus. We did not observe concomitant organisms in the nasal cultures and bottles in any subject.

CONCLUSION

Despite using a motorized irrigation device, patients and their bottles grew positive cultures. However, no cross-contamination between the patients and bottles was identified, which can be attributed to a design that minimizes backwash.