PILOT CLINICAL TRIAL TO ASSESS THE IMPACT OF ORAL INTERVENTION WITH CETYLPYRIDINIUM CHLORIDE ON REDUCING THE VIRAL LOAD OF SARS-CoV2

INTRODUCTION: The coronavirus disease pandemic 2019 (COVID‐19) constitutes a Public Health emergency. SARS‐CoV‐2 binds to angiotensin‐converting enzyme 2 and serine transmembrane protease 2 receptors, which are highly expressed in salivary glands, tongue and sulcular epithelium. Intervention aimed at reducing viral load in saliva through rinses may help control and decrease viral transmission. OBJECTIVES: To determine the efficacy of cetylpyridinium chloride (CPC) mouth rinses in reducing the salivary viral load of SARS‐CoV‐2 in COVID‐19 patients with less than 4 days of evolution. MATERIAL AND METHOD: Eighty SARS‐CoV‐2 positive patients were recruited and randomly assigned to two groups: a CPC intervention group (n=40) and a water control group (n=40). Saliva samples were collected from the patients at the time of diagnosis and within 2 hours after application of CPC/water rinses. Samples were subjected to RT‐PCR and ELISA analysis. RESULTS: Patients had a mean age of 48.6 years and 60% were male, with no significant differences between the two groups. With RT‐PCR analysis, we found no statistically significant differences in viral load reduction in the CPC mouthwash group. With the ELISA technique, there were no baseline differences between the two groups; however, 2 hours after rinsing, a significantly higher amount of nucleocapsids was observed in the CPC group versus the control group (CPC group; Mean:288.43, SD: 367.73, control group: Mean: 188.76, SD: 366.01; p<0.038) which we interpreted as a destructive action of CPC. CONCLUSIONS: The use of CPC in mouthwashes could be useful in reducing viral load, which may have an impact on the reduction of COVID‐19 transmission. This pilot trial should lead to further investigations with larger sample sizes.