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Can nasal sprays help combat COVID-19?

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The nose is the initial dominant site of viral infection, replication, and transmission and nasal sprays might be the answer to stop the spread.

While sanitising our hands has become routine, experts are suggesting that sanitising our noses and mouths before and after wearing a mask should become the norm too. Recent clinical trials conducted in the UK have shown that nasal sprays are both a safe and effective antiviral treatment to prevent COVID-19 transmission and symptom duration. These were also found to reduce symptom severity and damage in those already infected. In an interview with Omnia Health Insights, Dr. Jesse Pelletier, President of Halodine, an FDA registered, and science-backed nasal antiseptic solution designed to stop the spread of the coronavirus at its source, discusses how nasal sprays work and if they have any side effects. Excerpts:

How can nasal sprays help in combatting COVID-19? Is there research to support its efficacy?

Nasal sprays can be beneficial in combatting COVID-19. Once it was established that the primary means of SARS-CoV-2 transmission was through aerosols and droplets, the nose becomes the initial dominant site of viral infection, replication, and transmission. This is because we do the majority of breathing through our nose. The nose fulfils a critical role in cleansing and humidifying the air that is destined for our lower respiratory tree. It also, in conjunction with our mouth, is responsible for producing aerosols and droplets that may infect others. Nasal sprays which may inactivate the virus can, therefore, act in two ways. If one is infected with SARS-CoV-2 they can decrease the viral load or viral titers, making one less infectious to others and acting as a form of source control. On the other hand, if one is healthy, using a nasal spray that inactivates the virus may act as a means of chemical protection to mitigate or prevent infection altogether.

Can nasal sprays be used by all age groups? Are there any side effects?

The only evidence-based viricidal nasal spray that is currently available is Halodine which contains the antiseptic povidone-iodine as an active pharmaceutical ingredient (API). The spray is safe for use in most age groups. Its use in children under the age of three should be guided by discussion with one’s paediatrician. The side effects can include some tingling or stinging at the application site that lasts for a few minutes. It should not be used in those who suffer from thyroid disease, are pregnant or have an allergy to iodine-containing products. Other nasal sprays under investigation at this time include those which contain nitric oxide, carrageenan isolated from red seaweed or other polysaccharides.

Halodine represents an extra layer of protection against SARS-CoV-2 and should be used in conjunction with masks and other mitigating measures. The spray provides an additional layer of protection for up to four hours. Halodine has published research regarding its formulation in both the Journal of Prosthodontics and the Journal of the American Medical Association (JAMA). The latter manuscript has been adopted by the CDC and placed in the Thacker library to better inform clinicians and researchers regarding COVID management and therapeutics. Continued study with our API has shown a benefit in reducing RNA quantification via PCR, reducing infectious viral titers, and speeding viral clearance. Using Halodine nasal spray along with oral gargles may go a long way in helping break ascendant viral chains of transmission during this pandemic.

How important is it to continue to practice measures to protect ourselves even after being vaccinated?

Despite excellent protection against disease afforded by vaccination, we will likely continue to transmit the virus from our nose and mouth. This is in part due to the difference between systemic and mucosal immunity as the latter is driven by secretory IgA and may be less robust with current vaccination strategies. We are also witness to the evolutionary biology of SARS-CoV-2 as it continues to change based on Darwinian principles. New viral mutations have led to numerous variants which may influence a variety of factors including transmission, the severity of the disease, testing and the neutralising ability of antibodies created through vaccination. Some of these variants have undermined the neutralising ability of our vaccines making infection, transmission, and even mild disease more likely.

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