Saline nasal irrigation and gargling in COVID-19

来源: 盈盈一笑间于 2023-11-17 03:22:33 [档案] [博客] [旧帖] [给我悄悄话] 本文已被阅读：次 (6583 bytes)

“传统老方法”，以盐水漱喉咙、洗鼻，对付新冠确实管用，持续14天住院率降4成

https://www.wenxuecity.com/news/2023/11/16/125282551.html

Saline nasal irrigation and gargling in COVID-19: a multidisciplinary review of effects on viral load, mucosal dynamics, and patient outcomes

Abstract

With unrelenting SARS-CoV-2 variants, additional COVID-19 mitigation strategies are needed. Oral and nasal saline irrigation (SI) is a traditional approach for respiratory infections/diseases. As a multidisciplinary network with expertise/experience with saline, we conducted a narrative review to examine mechanisms of action and clinical outcomes associated with nasal SI, gargling, spray, or nebulization in COVID-19. SI was found to reduce SARS-CoV-2 nasopharyngeal loads and hasten viral clearance. Other mechanisms may involve inhibition of viral replication, bioaerosol reduction, improved mucociliary clearance, modulation of ENaC, and neutrophil responses. Prophylaxis was documented adjunctive to personal protective equipment. COVID-19 patients experienced significant symptom relief, while overall data suggest lower hospitalization risk. We found no harm and hence recommend SI use, as safe, inexpensive, and easy-to-use hygiene measure, complementary to hand washing or mask-wearing. In view of mainly small studies, large well-controlled or surveillance studies can help to further validate the outcomes and to implement its use.

Keywords: saline, COVID-19, nasal irrigation, gargling, nebulization, nasal spray, respiratory infection

Go to:

Keypoints

Oronasal saline irrigation is an inexpensive intervention to prevent and relieve common colds and upper respiratory infections.
COVID-19 patients may also benefit, as saline irrigation of the nose and throat was found to reduce nasopharyngeal viral load, fasten viral clearance, and relieve symptoms of COVID-19.
Overall, the small studies point to a potential benefit of saline irrigation on transmission, hospitalization, oxygen need, ICU admission, and/or mortality; confirmation in large trials is warranted.
Mechanisms of saline include, apart from the rinse effect that can limit micro-aspiration of virus and secretions from the nasopharynx to deeper airways and lungs, also direct effects of iso- or mild hypertonic saline on SARS-CoV-2 replication (impairment of growth and fusion in vitro), mucosal hydration, mucociliary clearance, ENaC channel activity, and obstructive mucus/NET formation, all mechanisms that can help to reduce and prevent the development of more invasive severe disease.
Oral and nasal saline rinsing can be considered for prevention and as an early intervention in SARS-CoV-2 infection, adjunctive to current standard protection including mask wear, distancing, and hand hygiene.
Saline nebulization can be considered in patients who cannot do saline irrigation, or with lower respiratory tract signs or symptoms: The released bioaerosol does not contain live virus.