1. very low concentration of CHX (0.01- 0.02% w/v) 2. only as a surface disinfectant 3. Tested against viruses other than SARS-COV-2.
This had given an erroneous impression that CHX may not be useful against SARS-COV-2.
But that was only till March 2020.
Latest evidence 1:
1. Lancet journal study (in vitro) published (April 2020) by Hong Kong university researchers showed that Chlorhexidine inactivated the virus at 0.05% w/v
2. Korean study (clinical study in patients as a mouthwash, May 2020) showed that Chlorhexidine reduced #SARSCOV2 viral load in saliva for 2 hrs. After 2 hrs viral load in saliva began to rise. This low viral load phase is important in clinic & community.
Real world implications: 1. Doctors can complete their check up & clinical procedures in 2 hrs. 2. People getting into domestic flights can use CHX mouthwash & prevent spread inside the aircraft. 3. People who are in home quarantine can prevent spread to family members. #COVID19
#COVID19 spreads by droplets in close contact. It can spread via coughing, sneezing & even talking because Saliva contains high viral loads #SARSCOV2. A single rinse with Chlorhexidine can reduce this viral load in saliva. 10 ml of 0.20% CHX mouthwash be used for 30 sec.
Analysis of all early studies done on Chlorhexidine that gave an erroneous impression that CHX may not be effective against #nCoV2019#SARSCoV2 plus the latest Lancet study (Apr 2020) showing CHX to be effective against SARS-COV-2. My Researchgate article researchgate.net/publication/34…
It's time to add Chlorhexidine to the #COVID19 prevention protocols
Before moving out of your home 1. Use Chlorhexidine mouthwash. 10 ml of 0.20% w/v CHX rinsed for 30 sec (10- 20- 30 rule) 2. Wear the right mask the right way 3. Well fitting Eyewear 4. Physical distancing
Can we give the same confidence with other mouth rinses like Povidone Iodine, Essential oil mouthwashes, Hydrogen peroxide, Hypochlorous acid?
The answer is NOT YET.
None of them has been tested clinically against SARS-COV-2 to show how long they can reduce the viral loads.
Chlorhexidine in OT: Dexter et al (July 2020)
Infection control in Operation Theatres during COVID-19
1. Alcohol hand rubs 2. Wipes with Quarternary Ammonium Compounds & Alcohol for equipment
surfaces 3. Preprocedural Chlorhexidine wipes & mouth rinses journals.lww.com/anesthesia-ana…
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Neutralizing antibodies are a good indicator of protection,
- not only against severe disease
- but also (if amounts are very high) against viral replication in the mucosa (with or without symptoms), thereby reducing transmission. #COVID19
1/ Omicron's 3 mutations (P681H, H655Y, N679K) in furin cleavage site region were initially predicted to favor its pathogenicity: cell-cell fusion & syncytia formation.
But reality is different.
Omicron's cleavage efficiency is substantially lower than Delta variant. #COVID19
2/ Omicron spike is relatively poorly cleaved.
It shows impaired entry & replication in lung cells that express TMPRSS2, a serine protease enriched in lung alveolar type 1 & 2 cells.
This reduced cleavage is also associated with poorer cell-cell fusion and syncytia formation.
3/ Cell-cell fusion mediated by spike glycoprotein requires S1/S2 cleavage, but is also dependent on TMPRSS2 presence.
Fusogenicity of Omicron spike was severely impaired despite TMPRSS2 expression, leading to marked reduction in syncytium formation compared to Delta spike.