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Source: Medical News - SARS-CoV-2 And Saline Nasal Irrigation  Sep 13, 2022  9 months ago
American Study Shows That Twice A Day Nasal Irrigation With Saline Solution Helps Prevents COVID-19 Disease Severity And Mortality!
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American Study Shows That Twice A Day Nasal Irrigation With Saline Solution Helps Prevents COVID-19 Disease Severity And Mortality!
Source: Medical News - SARS-CoV-2 And Saline Nasal Irrigation  Sep 13, 2022  9 months ago
Its interesting to note that when Chinese scientists in early 2020 suggested that rising ones mouth and nasal cavities with saline solution could help prevent COVID-19 severity as a result of reducing viral loads and viral reservoirs in these regions which are the preferred gateways of the novel coronavirus into the human host, many ‘bastard’ journalist and charlatan ‘fact checkers’ who have no proper scientific backgrounds from the West and also from India, Africa and Italy were quick to dismiss the claims as fake news. ‘Dogs’ employed by Facebook as factcheckers and also certain unreliable medical sites also were quick to dismiss the claims without even attempting to check the claims from a scientific perspective!
(Note that both Reuters and AFP are the biggest disseminators of fake medical news online and most of their garbage journalist have no medical backgrounds but shockingly most of their contents generated by them can be found on medical sites like Medscape, WebMD etc!)
Fast forward, deservingly, the regions where the most COVID-19 deaths were observed and infections rates extremely high were countries with such garbage journalists or “fact-checkers;’ ie the United States, Europe and India.
In fact, there are already many studies published that show saline water does inhibit the SARS-CoV-2 coronavirus.
It is surprising that till now, no one ever went after these garbage journalists or fact checkers or garbage wire agencies and news outlets legally and make them pay dearly for their misinformation!
One early detailed study that never made in to the journals in fact had a lot of supporting data on the usage of saline water against SARS-CoV-2.
Another site by a group of doctors from Washington, was also one of the early advocates of using saline in the COVID-19 crisis.
Now, American clinical researchers from the Department of Emergency Medicine, Augusta University, have in a new study validated that saline nasal irrigation twice a day does help to reduce COVID-19 severity and mortality!
The study team conducted the research to in order see if initiating saline nasal irrigation after COVID-19 diagnosis reduces hospitalization and death in high-risk outpatients compared with observational controls, and if irrigant composition impacts severity.
Study participants 55 and older were enrolled within 24 hours of a + PCR COVID-19 test between September 24 and December 21, 2020. Among 826 screened, 79 participants were enrolled and randomly assigned to add 2.5 mL povidone-iodine 10% or 2.5 mL sodium bicarbonate to 240 mL of isotonic nasal irrigation twice daily for 14 days. The primary outcome was hospitalization or death from COVID-19 within 28 days of enrollment by daily self-report confirmed with phone calls and hospital records, compared to the CDC Surveillance Dataset covering the same time. Secondary outcomes compared symptom resolution by irrigant additive.
A total of seventy-nine high-risk participants were enrolled (mean [SD] age, 64 [8] years; 36 [46%] women; 71% Non-Hispanic White), with mean BMI 30.3.
Analyzed by intention-to-treat, by day 28, COVID-19 symptoms resulted in one ED visit and no hospitalizations in 42 irrigating with alkalinization, one hospitalization of 37 in the povidone-iodine group, (1.27%) and no deaths.
Of nearly three million CDC cases, 9.47% were known to be hospitalized, with an additional 1.5% mortality in those without hospitalization data. Age, sex, and percentage with pre-existing conditions did not significantly differ by exact binomial test from the CDC dataset, while reported race and hospitalization rate did. The total risk of hospitalization or death (11%) was 8.57 times that of enrolled nasal irrigation participants (SE = 2.74; P = .006). Sixty-two participants completed daily surveys (78%), averaging 1.8 irrigations/day. Eleven reported irrigation-related complaints and four discontinued use. Symptom resolution was more likely for those reporting twice daily irrigation (X2 = 8.728, P = .0031) regardless of additive.
The study findings showed that SARS-CoV-2+ participants initiating nasal irrigation were over 8 times less likely to be hospitalized than the national rate.
More importantly the study findings showed that starting twice daily flushing of the mucus-lined nasal cavity with a mild saline solution soon after testing positive for COVID-19 significantly reduced hospitalization and death.
The study findings were published in the peer reviewed journal: Ear, Nose, Throat Journal.
The study team said that the nasal irrigation protocol can be easily conducted at home by mixing a half teaspoon each of salt and baking soda in a cup of boiled or distilled water then putting it into a sinus rinse bottle is a safe, effective and inexpensive way to reduce the risk of severe illness and death from coronavirus infection that could have a vital public health impact.
Corresponding author Dr Amy Baxter, an emergency medicine physician at the Medical College of Georgia at Augusta University told Thailand Medical News, "What we say in the emergency room and surgery is the solution to pollution is dilution. By giving extra hydration to your sinuses, it makes them function better. If you have a contaminant, the more you flush it out, the better you are able to get rid of dirt, viruses and anything else.”
Senior author Dr Richard Schwartz, chair of the Medical College of Georgia’s Department of Emergency Medicine added, "We found an 8.5-fold reduction in hospitalizations and no fatalities compared to our controls. Both of those are pretty significant endpoints."
The research appears to be the largest, prospective clinical trial of its kind and the older, high-risk population the team studied…many of whom had preexisting conditions like obesity and hypertension..may benefit most from the easy, inexpensive practice.
The study team found that less than 1.3% of the 79 study subjects age 55 and older who enrolled within 24-hours of testing positive for COVID-19 between Sept. 24 and Dec. 21, 2020, experienced hospitalization. No one died.
The study team said that among the participants, who were treated at MCG and the AU Health System and followed for 28 days, one participant was admitted to the hospital and another went to the emergency room but was not admitted.
Interestingly, by comparison, 9.47% of patients were hospitalized and 1.5% died in a group with similar demographics reported by the Centers for Disease Control and Prevention during the same timeframe, which began about nine months after SARS-CoV-2 first surfaced in the United States.
The study team added, "The reduction from 11% to 1.3% as of November 2021 would have corresponded in absolute terms to over 1 million fewer older Americans requiring admission. If confirmed in other studies, the potential reduction in morbidity and mortality worldwide could be profound."
Dr Schwartz said that Dr  Baxter brought him the idea early in the pandemic and he liked that it as it was inexpensive, easy to use and could potentially impact millions at a time where, like other health care facilities, the Emergency Department of the AU Health System was starting to see a lot of SARS-CoV-2-positive patients.
Dr Schwartz further added, "We were really looking at what options we had available for treatment. The first COVID-19 vaccines were given in December 2020 and the first treatment, the antiviral remdesivir was approved by the Food and Drug Administration in October 2020. We knew that the more virus that was present in the body, the worse the impact.”
Dr Baxter added, "One of our thoughts was: If we can rinse out some of the virus within 24 hours of them testing positive, then maybe we can lower the severity of that whole trajectory, including reducing the likelihood the virus could get into the lungs, where it was doing permanent, often lethal damage to many.”
She added, “Additionally, the now-infamous spiky SARS-CoV-2 is known to attach to the ACE2 receptor, which is pervasive throughout the body and in abundance in locations like the nasal cavity, mouth and lungs, the nasal irrigation with saline helps decrease the usual robust attachment. Saline appears to inhibit the virus' ability to essentially make two cuts in itself, called furin cleavage, so it can better fit into an ACE2 receptor once it spots one.”
Study participants self-administered nasal irrigation using either povidone-iodine, that brown antiseptic that gets painted on your body before surgery, or sodium bicarbonate, or baking soda, which is often used as a cleanser, mixed with water that had the same salt concentration normally found in the body.
Although the study team found the additives really added no value, previous research had indicated they might help, for example, making it more difficult for the virus to attach to the ACE2 receptor.
However, the study findings showed that plain saline solution alone sufficed.
The study team wanted to know any impact on symptom severity, like chills and loss of taste and smell.
Interestingly, twenty-three of the 29 participants who consistently irrigated twice daily had zero or one symptom at the end of two weeks compared to 14 of the 33 who were less diligent.
Also, those who completed nasal irrigation twice daily reported quicker resolution of symptoms regardless of which of two common antiseptics they were adding to the saline water.
In all, a total of sixty-two of the participants completed a daily survey, reporting 1.8 irrigations daily; 11 reported irrigation-related complaints and four discontinued use.
Both study participants and those used as controls had similar ages and rates of common conditions including one or more preexisting health problems. Older adults, those with obesity and excess weight, who are physically inactive and those with underlying medical conditions are considered most at risk for serious complications and hospitalization from COVID-19. A body mass index, or BMI, which measures weight in relation to height, between 18.5 and 24.9, is considered ideal, and study participants had a mean BMI of 30.3; over 30 indicates obesity.
Dr Baxter added that past studies had already shown that nasal irrigation, also called lavage, can also be effective in reducing duration and severity of infection by a family of viruses that include the coronaviruses, which are also known to cause the common cold, as well as the influenza viruses.
She added that SARS-CoV-2 infection was another perfect situation for it.
Dr Baxter noted that in fact, nasal irrigation is something that has been done for millennia in Southeast Asia, and she had noted lower death rates from COVID-19 in countries like Laos, Vietnam and Thailand.
She said, "Those were places that I knew from having been there where they use nasal irrigation as a normal part of hygiene just like brushing their teeth."
She added that a 2019 pre-COVID study provided evidence that regular nasal irrigation in Thailand can improve nasal congestion, decrease postnasal drip, improve sinus pain or headache, improve taste and smell and improve sleep quality.
Dr Schwartz said the simplicity and safety of the treatment had him recommending nasal irrigation to positive patients early on and the published results make him even more confident in recommending nasal irrigation to essentially anyone who tests positive.
Dr Baxter noted the skepticism of the medical community before the results could be peer reviewed and published and her frustration with this relatively simple approach not being used when so many were sick and dying.
She said, "Many of the individuals who have been using this now for months have told me their seasonal allergies have gone away, that it really makes a huge difference in any of the things that go through the nose that are annoying."
A few new studies indicated that gargling with a saline-based solution can reduce viral load in COVID-19, and another released in 2021 suggested that saline works multiple ways to reduce cold symptoms related to infection with other coronaviruses and might work as well as a first-line intervention for COVID-19.
For more on Saline and SARS-C0V-2, keep on logging to Thailand Medical News.


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