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COVID-19: Brief Communication
Hydrogen peroxide as an auxiliary treatment for COVID-19 in Brazil: a randomized double-blind clinical trial
Marielle Bazzo Di Domênico, Kauê Collares, Renan Brandenburg dos Santos, Ulysses Lenz, Vinícius Picoli Antunes, Vinicius Webber Godinho, Henrique Cesca, Thales Henrique Jincziwski Ponciano, Pedro Henrique Corazza
Epidemiol Health. 2021;43:e2021051.   Published online August 3, 2021
DOI: https://doi.org/10.4178/epih.e2021051
  • 12,994 View
  • 271 Download
  • 6 Web of Science
  • 4 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
This study evaluated the effectiveness of hydrogen peroxide (H<sub>2</sub>O<sub>2</sub>) as mouthwash and nasal spray on symptom relief in coronavirus disease 2019 (COVID-19) patients.
METHODS
Patients positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), who were treated in a hospital or at home, and patients’ family members (not positive for SARS-CoV-2), were randomized into 2 groups: experimental (1% H<sub>2</sub>O<sub>2</sub> for gargling, 0.5% H<sub>2</sub>O<sub>2</sub> for nasal wash), and control. Patients gargled the solution 3 times a day, and applied the nasal spray twice a day, for a 7-day period. Family members received the same treatment as the treated COVID-19 patient. The researchers contacted patients every 2 days over an 8-day period. An average post-treatment interval of 8 days passed before testing family members.
RESULTS
The most frequent symptoms on day 0 were cough, loss of taste, and hyposmia; there were no significant differences between groups, independent of the period. The symptom of dyspnea presented a significant difference between days 2 and 4 (p<0.05). Among family members, 86.0% had no antibodies, 2.3% had antibodies, and 11.6% had active infections (4 in the experimental group and 6 in the control group). The most frequent adverse effects in the H<sub>2</sub>O<sub>2</sub> group were a burning throat and nose.
CONCLUSIONS
H<sub>2</sub>O<sub>2</sub> was not effective for the relief of COVID-19 symptoms and was associated with reports of transient adverse effects.
Summary
Key Message
The hydrogen peroxide (H2O2) at low concentrations disrupts the lipid membranes of some viruses through the action of oxygen free radicals. Nevertheless, the data obtained in the present study demonstrated that the use of the H2O2 as mouthwash and nasal spray was not effective on symptom relief in patients with COVID-19. Moreover, it was associated with transient adverse effects such as burning sensations in the nose and throat. Thus, the authors of this study advise against the use of H2O2 as a mouthwash and nasal spray to relieve COVID-19 symptoms and transmission.

Citations

Citations to this article as recorded by  
  • Seawater nasal wash to reduce symptom duration and viral load in COVID-19 and upper respiratory tract infections: a randomized controlled multicenter trial
    Ludovic de Gabory, Sophie Vallet, Gaëlle Naelten, Chantal Raherison-Semjen
    European Archives of Oto-Rhino-Laryngology.2024;[Epub]     CrossRef
  • Preprocedural Viral Load Effects of Oral Antiseptics on SARS-CoV-2 in Patients with COVID-19: A Systematic Review
    Miriam Ting, Alex Dahlkemper, Jeremy J. Schwartz, Manzel Woodfork, Jon B. Suzuki
    Biomedicines.2023; 11(6): 1694.     CrossRef
  • Efficacy of Mouth Rinses and Nasal Spray in the Inactivation of SARS-CoV-2: A Systematic Review and Meta-Analysis of In Vitro and In Vivo Studies
    Majdy Idrees, Bridget McGowan, Amr Fawzy, Abdulwahab Ali Abuderman, Ramesh Balasubramaniam, Omar Kujan
    International Journal of Environmental Research and Public Health.2022; 19(19): 12148.     CrossRef
  • Enhanced Nasal Deposition and Anti-Coronavirus Effect of Favipiravir-Loaded Mucoadhesive Chitosan–Alginate Nanoparticles
    Khent Primo Alcantara, Nonthaneth Nalinratana, Nopporn Chutiwitoonchai, Agnes L. Castillo, Wijit Banlunara, Opa Vajragupta, Pornchai Rojsitthisak, Pranee Rojsitthisak
    Pharmaceutics.2022; 14(12): 2680.     CrossRef
COVID-19: Original Article
Effectiveness of hydrogen peroxide as auxiliary treatment for hospitalized COVID-19 patients in Brazil: preliminary results of a randomized double-blind clinical trial
Marielle Bazzo Di Domênico, Henrique Cesca, Thales Henrique Jincziwski Ponciano, Renan Brandenburg dos Santos, Ulysses Lenz, Vinícius Picoli Antunes, Vinicius Webber Godinho, Kauê Collares, Pedro Henrique Corazza
Epidemiol Health. 2021;43:e2021032.   Published online May 1, 2021
DOI: https://doi.org/10.4178/epih.e2021032
  • 14,963 View
  • 411 Download
  • 6 Web of Science
  • 3 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
To evaluate the effectiveness of hydrogen peroxide (H2O2) in the form of mouthwash and nasal spray as an auxiliary treatment for coronavirus disease 2019 (COVID-19).
METHODS
Forty hospitalized patients who tested positive for severe acute respiratory syndrome coronavirus 2 using a reverse-transcription polymerase chain reaction test were evaluated. They were randomly divided into an experimental group (n= 20; gargling with 1.0% H2O2 and nasal wash with 0.5% H2O2) or a control group (n= 20). The solutions were used for 7 days and the patients were monitored every 2 days, for a total of 8 days. At check-ups, patients were asked about their symptoms and possible adverse effects of the solutions. The presence and severity (mild, moderate, or severe) of symptoms were recorded. Data were compared using the Student test and the Fisher exact test (α= 0.05).
RESULTS
There was no significant difference between the 2 groups in the length of hospital stay (p= 0.65). The most frequent symptom on day 0 was coughing (72.0% in the experimental group and 76.5% in the control group), which abated over time. There was no significant difference between the groups in the evaluated symptoms. Most (75.0%) of the patients in the experimental group presented a reduction in dyspnea between days 0 and 2. Few patients reported adverse effects from the use of the solutions.
CONCLUSIONS
H2O2 as a mouthwash and nasal spray is safe to use. There is insufficient evidence to demonstrate that H2O2 is effective as an auxiliary treatment for hospitalized COVID-19 patients.
Summary
Key Message
Despite some improvement trends in the symptom 'difficulty breathing', the effectiveness of the mouthwash and nasal spray of H2O2 for COVID-19 hospitalized patients was not proven yet.

Citations

Citations to this article as recorded by  
  • Preprocedural Viral Load Effects of Oral Antiseptics on SARS-CoV-2 in Patients with COVID-19: A Systematic Review
    Miriam Ting, Alex Dahlkemper, Jeremy J. Schwartz, Manzel Woodfork, Jon B. Suzuki
    Biomedicines.2023; 11(6): 1694.     CrossRef
  • The effectiveness of mouthwash against SARS-CoV-2 infection: A review of scientific and clinical evidence
    Ming-Hsu Chen, Po-Chun Chang
    Journal of the Formosan Medical Association.2022; 121(5): 879.     CrossRef
  • Hydrogen peroxide as an auxiliary treatment for COVID-19 in Brazil: a randomized double-blind clinical trial
    Marielle Bazzo Di Domênico, Kauê Collares, Renan Brandenburg dos Santos, Ulysses Lenz, Vinícius Picoli Antunes, Vinicius Webber Godinho, Henrique Cesca, Thales Henrique Jincziwski Ponciano, Pedro Henrique Corazza
    Epidemiology and Health.2021; 43: e2021051.     CrossRef
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