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Povidone Iodine Nasal Spray for Coronavirus

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Rob (Kentucky) on 08/29/2020:
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Povidone Iodine Nasal Spray are now being issued to front-line health care workers and hospital patients for covid19 related illness.

Note from Rob: I am writing and presenting this article to Earthclinic in the hope it will help someone or a family member reading your forum with a compromised immune system. Covid19 seems to be hitting them the hardest. It has become “blasphemy” in America to speak publicly about cures for covid19. I am a herbalist and back in early November 2019, people were coming to me with some screwed up symptoms which I called an SSV (some sorta virus?). I did not know what it was, so I was giving them my Cold and Flu Remedy. If they were able to treat their symptoms fast enough within 48 hours, they were over the flu(?) in about 12 hours.

For every 24hrs over the 48hr mark untreated, you can add another 12hrs to recover. Then in late December, rumors started coming out of China about a virus with the same symptoms I was treating. Huh, imagine that… And as of today 8/2020 it’s still knocking it out. What I am trying to say is don’t believe everything the media and your politicians are telling you. Here are cures out there, their just too cheap, all natural and big pharma can’t make a profit on it.

This treatment is not a cure for Covid19. It is meant to reduce the viral load inside the nasal cavities where the covid19 and other micro-organisms collect and become dangerous. Summit Biosciences, Inc. announced this week it had been awarded a contract from a Seattle-based pharmaceutical company, Atossa Therapeutics, Inc., to fast track the development of a nasal spray to be used on patients who’ve been diagnosed with the novel coronavirus but who “have not yet exhibited symptoms severe enough to require hospitalization, ”according to the press release.

Lexington KY pharmaceutical company developing nasal spray to treat COVID-19 (Press Release) https://www.kentucky.com/news/coronavirus/article243092566.html

COVID-19 is a viral respiratory disease that often initially settles in the nose — one of the most widely used tests to determine whether a person actively has the new coronavirus is a nasal swab — which is why the company is working to produce a nasal spray. Typically, as the infection becomes more severe, it will move to the lungs, where it can become deadly. The point with this drug is to catch it early enough, before that happens.

In order for the virus’ spike proteins to take hold in a person’s nasal cavity, certain cells in the mucus must first activate that viral spike protein. This nasal spray would inhibit that activation process, acting as a “barrier inside the nose to prevent virus entry”.

Researchers at the University of Kentucky in three clinical trials to treat symptoms of those who’ve already tested positive for the virus and help them avoid needing to be hospitalized, and to develop a drug that prevents transmission of the virus. “We are looking for a therapy that prevents people from having to go to the hospital, or if they happen to be in the hospital and are not critically ill, [from] becoming critically ill”.

One of the clinical trials involves testing the efficacy of an iodine nasal spray to protect people who are at especially high risk from contracting the virus, including frontline health care workers.

Summit Bioscience’s nasal spray would be targeted toward healthier people who’ve tested positive but don’t have severe symptoms. To be used at home, the nasal spray would work to keep them from developing those symptoms as well as to slow the infection rate, overall, putting their immune system in a better position to fight the virus. The goal is to eventually commercialize therapies for patients “on both ends of the spectrum, ”— those healthier patients well enough to be treated at home, and sicker patients who may require a ventilator.

DIY Povidone-iodine Nasal Spray:

Regularly use 2 – 5 times a daily with a Nasal Spray Irrigator and home-made saline. University of Kentucky Hospital, USA did the study. Study subjects will use betadine saline sinus rinse for period of 7 days.

Povidone iodine is a powerful antiseptic and disinfectant. In contact with skin and mucous membranes povidone iodine works quickly and has a microbicidal effect (causing the death of a broad spectrum of bacteria, fungi, viruses and protozoa).

Recipe #1:

Material needed:

*30 ml empty nasal spray bottle

*Distilled water

*Sea salt

*Baking soda

*Povidone-iodine 10%

*Empty clean water bottle

*Peppermint oil (optional)

1. Add 1 teaspoon sea salt and 1 teaspoon baking soda to empty “clean” 17 oz water bottle.

2. Add distilled water to bottle, cap and shake til salt and baking soda have completely dissolved. This is your saline solution.

3. Add 3ml of Povidone-iodine (you want it strong since Povidone Iodine solution 5% has only 0.5% available iodine) to the empty nasal spray bottle. 2 drops peppermint oil (optional but it is a good anti-inflammatory). Top bottle off with your saline solution.

4. Use this spray twice in each nostrile 2-5 times daily for afew weeks to resolve sinus infections, congestion and polyps.

Recipe #2:

Material needed:

*Saline Nasal Squeeze Bottle (New with saline water inside purchase from store)

*Child medicine syringe or similar device that measures in milliters

*Povidone-iodine 10%

1. Remove nasal tip from Saline Nasal Squeeze Bottle.

2. Estimate how much PVP-I to add to nasal bottle based on how much saline is inside. General formula is 1ml PVP-I to every 10ml saline water.

3. Using the child syringe, remove the same amount saline water as you are going to add in.

4. Re-cap nasal cap to bottle. Shake well and spray up each nostile.

The science behind this:

Povidone-iodine (PVP-I) is a broad-spectrum antiseptic with activity against bacteria, fungi, and viruses. It has been previously used in both intranasal preparations against Methicillin Resistant Staphylococcus Aureus (MRSA) as well as oral preparations in in-vitro studies of Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV), Middle Eastern Respiratory Syndrome Coronavirus (MERS-CoV), influenza H1N1, and rotavirus with good efficacy. This study will evaluate the efficacy of PVP-I as prophylaxis in Coronavirus Disease 2019 (COVID19)-negative for front-line health care workers and hospital patients.

The highest concentration of viral covid-19 particles resides within the nasopharynx. The virus is thought to spread via respiratory droplets with the potential for transmission via inhalation of droplets, contact to the nose and mouth with infected materials, and airborne transmission. Given that frontline workers are involved in high-risk procedures including intubation, bronchoscopy, proning patients (which can lead to droplet production) and in some cases are reusing PPE, finding ways to reduce viral load or viral exposure are paramount.

In this study, front line healthcare workers will be asked to complete a pre-participation survey and screened for COVID positivity. They will then be given premade PVP-I gargles and nasal sprays, as well as a calendar card to mark compliance. PVP-I nasal spray and gargle (10% diluted 1:30) will be used prior to the start of a shift, during "lunch break", and at the end of shift. First, the nasal spray will be sprayed in the nose (2 sprays each nostril). For adequate coverage, the participant should be able to taste the iodine or see it in the back of the throat. This should be left in place for 30 seconds. Then, the participant will gargle the solution for 30 seconds and not have anything to eat or drink by mouth for 30 minutes. Treatment will continue for 3 weeks, or until the healthcare worker presents with COVID symptoms. Participants will then be tested for COVID positivity and asked to fill out a second questionnaire assessing study tolerability. At completion of the study, they will be asked to turn in their calendar card to assess how many applications they were able to complete.

Given the high rate of asymptomatic carriers, a second arm will also be planned for patients who have a 7+ day hospitalization or who are set to undergo a significant surgical procedure. These patients will be offered participation in the study as well and will be given the same questionnaire and undergo preoperative testing if they consent. For patients in the study group, PVIP gargle and nasal sprays will be applied preoperatively or shortly after admission and enrollment in the study for the non-operative group. The patients will then be retested in 2 weeks or as directed by the presentation of symptoms concerning for infection with SARS-CoV-2.

Due to the known breadth of its antiviral activity and similarities in molecular structure, it can be extrapolated that PVP-I should have robust activity against SARS-CoV-2. Eggers et al found that at a concentration of 1% there was a reduction of viral activity of 99.99% in in-vitro assays. At 2 minutes, a concentration of 0.23% was enough to reduce viral loads appreciably (meaning measurable).

Introduction:

There have been significant concerns noted regarding infection of health care workers and subsequent nosocomial spread within hospitals. Data from the epidemic in Wuhan by the Chinese Center for Disease Control and Prevention noted that 63% of infected patients in Wuhan were health care workers.1 A study of hospitalized patients at a tertiary care center in Wuhan noted that 12% of patients and 29% of health care professionals had acquired COVID-19 from nosocomial spread. Particular concern has been expressed regarding the safety of otolaryngologists, patients, and staff during routine and endoscopic examination. Reports have demonstrated high viral loads of SARS-CoV-2 in the nasal cavities, nasopharynx, oral cavities, and oropharynx, with the highest viral loads within the nasopharynx. In vitro studies have demonstrated that the tissue of the nose and mouth have high expression of ACE2, the main receptor of COVID-19. Nasal goblet and ciliated cells had the highest expression of ACE2. Due to high viral load, these areas are sensitive for diagnosis of the virus. The transit of virus via coughing, sneezing, and aerosolizing procedures makes transmission high. Aerosols of SARS-CoV-2 have been detected in the air for up to 3 hours. There are concerns that many otolaryngology procedures generate aerosols, which was proven for intranasal high-speed drilling in a cadaveric study.

Transmission reduction by the minimization of aerosolized virus is of key importance. Given that the nasopharynx and oropharynx are principal reservoirs of active SARS-CoV-2 virus, there has been immense desire for an approach to nasal and oral decontamination in the era of COVID-19. Povidone-iodine (PVP-I) has been suggested as a topical solution. PVP-I works by releasing free iodine, which disrupts microbial metabolic pathways, destabilizes structural components of cell membranes, and leads to irreversible damage to pathogens. It is a potent virucidal via inhibition of N1, N2, and N3 neuraminidase as well as inhibition of hemagglutinin. This inhibition blocks viral attachment to cellular receptors and inhibits viral release and spread from infected cells.

Protocols have been recommended regarding nasal and oral use of PVP-I in regard to the COVID-19 pandemic, and there has been much discussion regarding the implementation of these practices. A protocol was developed in the United Kingdom recommending 0.3 mL of 0.5% PVP-I solution via each nostril and 9 mL via the oral cavity in conscious COVID-19 patients and persons under investigation (PUIs) prior to undergoing procedures in and around the mouth, as well as in health care workers performing these procedures. In unconscious patients, they recommended applying 2 mL to the mucosal surfaces of the oral cavity. Use was recommended every 2 to 3 hours in health care workers exposed to these patients up to 4 times per day. Another protocol from Pittsburgh recommended 240 mL of 0.4% PVP-I in the nasal cavity via sinus rinse delivery bottle and 10 mL of 0.5% PVP-I oral wash every 2 to 3 hours up to 4 times per day in patients with COVID-19, PUIs, prior to high-risk procedures, and in COVID-19 hotspots. They recommended this procedure in health care workers prior to and after care of COVID patients, PUIs, high-risk procedures in COVID hotspots, and in the setting of inadequate PPE. Parhar et al concurred with the use of PVP-I based preparations to reduce viral loads of coronavirus as there was demonstrated efficacy. An anesthesia guideline for operative room care in the COVID-19 era recommended 2 doses of nasal PVP-I within 1 hour of incision for all OR cases. The American Dental Association guidelines for minimizing risk of COVID-19 transmission recommended preoperative use of 0.2% PVP-I mouthwash for all procedures.

To minimize toxicity when using PVP-I as a repeated application, most protocols recommend concentrations of PVP-I between 0.2% and 0.5%. Because nasal and oral viral loads are similar in asymptomatic and symptomatic patients3 and can persist in convalescent seroconverted cases, some of these protocols recommend the use of PVP-I in asymptomatic patients. Unaddressed in any report to date is a discussion of the interdependence of PVP-I aqueous concentration, chemical stability, reported toxicity, and known biocidal efficacy.

Most commercial PVP-I preparations suitable for sinonasal or oral application are aqueous concentrations of 10% PVP-I or 5% PVP-I intended for presurgical antisepsis. Although additional scrubs, solutions, swab sticks, and other PVP-I containing products are available in the 5% to 10% range, many contain additional salts, sudsing agents, and cosolvents that should be avoided in the nose and mouth. Most are specifically labeled for external use and carry warnings against exposure to eyes, ears, and mucosal surfaces. The chemical stability of PVP-I in aqueous solutions at room temperature declines with dilution, alkalinization, and contact with common low-density polymer packaging materials.22, 23 Naturally acidic aqueous PVP-I solutions reach a critical stability inflection point at about 0.75%.24 Paradoxically, studies have shown that the antibacterial activity of full-strength 10% PVP-I increases with dilution.25 Between 10% and 1%, there is an exponential increase in efficacy which plateaus between 1.0% and 0.1% before decreasing again from 0.1% to 0.001%.

Our objective is to present established uses of PVP-I in the sinonasal and oral cavities and outline the safety profile through the discussion of clinical and in vitro toxicity. In addition, we aim to discuss PVP-I efficacy against coronaviruses and its potential use specifically against SARS-CoV-2 to inform the otolaryngology community regarding its use.

Results:

Povidone-iodine has been safely administered for up to 5 months in the nasal cavity and 6 months in the oral cavity. Concentrations less than 2.5% in vitro do not reduce ciliary beat frequency or cause pathological changes in ciliated nasal epithelium, upper respiratory, or mucosal cells. Adverse events with oral use have not been reported in conscious adults or children. Allergy and contact sensitivity is rare. Chronic mucosal use up to 5% has not been shown to result in clinical thyroid disease. PVP-I is rapidly virucidal and inactivates Coronaviruses, including SARS-CoV and Middle East Respiratory Syndrome (MERS).

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