PVP-I for COVID-19: real-time analysis of all 26 studies

Povidone-Iodine for COVID-19: real-time meta analysis of 12 studies

Covid Analysis (Preprint) (meta analysis)

• Statistically significant improvements are seen for mortality, hospitalization, cases, and viral clearance. 6 studies from 4 different countries show statistically significant improvements in isolation (5 for the most serious outcome).

• Meta analysis using the most serious outcome reported shows 52% [36‑64%] improvement. Results are similar for Randomized Controlled Trials, similar after exclusions, and similar for peer-reviewed studies. Early treatment is more effective than late treatment.

• Results are robust — in exclusion sensitivity analysis 10 of 12 studies must be excluded to avoid finding statistically significant efficacy in pooled analysis.

• While many treatments have some level of efficacy, they do not replace vaccines and other measures to avoid infection. Only 17% of povidone-iodine studies show zero events in the treatment arm.

• Multiple treatments are typically used in combination, and other treatments may be more effective.

• Elimination of COVID-19 is a race against viral evolution. No treatment, vaccine, or intervention is 100% available and effective for all variants. All practical, effective, and safe means should be used, including treatments, as supported by Pfizer [Pfizer]. Denying the efficacy of treatments increases the risk of COVID-19 becoming endemic; and increases mortality, morbidity, and collateral damage.

• All data to reproduce this paper and sources are in the appendix.

	Studies	Early treatment	Late treatment	Prophylaxis	Patients	Authors
All studies	12	71% [46‑84%]	44% [19‑61%]	45% [20‑62%]	2,549	125
With exclusions	11	81% [63‑90%]	44% [19‑61%]	45% [20‑62%]	2,478	119
Peer-reviewed	10	72% [39‑87%]	44% [19‑61%]	45% [20‑62%]	2,460	100
RCTs	10	81% [63‑90%]	31% [8‑49%]	45% [20‑62%]	2,212	113
Percentage improvement with povidone-iodine treatment

Covid Analysis et al., 1/5/2022, preprint, 1 author.

Clinical evaluation of antiseptic mouth rinses to reduce salivary load of SARS-CoV-2

Ferrer et al., Scientific Reports, doi:10.1038/s41598-021-03461-y (Peer Reviewed)

Small very late (>50% 7+ days from symptom onset, 9 PVP-I patients) RCT testing mouthwashing with cetylpyridinium chloride, chlorhexidine, povidone-iodine, hydrogen peroxide, and distilled water, showing no significant differences. Over 30% of patients show >90% decrease in viral load @2 hrs with all 5. Authors note that a trend was observed for viral load decrease with PVP-I @2h for patients <6 days from onset (p=0.06, Wilcox test).

relative decrease in log viral load, 34.0% better, RR 0.66, p = 0.82, treatment 9, control 12, calculated from Supplementary Table 1.

Ferrer et al., 12/22/2021, Randomized Controlled Trial, Spain, Europe, peer-reviewed, 19 authors.

Determinants of Outcome Among Critically Ill Police Personnel With COVID-19: A Retrospective Observational Study From Andhra Pradesh, India

Jamir et al., Cureus, doi:10.7759/cureus.20394 (Peer Reviewed)

Retrospective 266 COVID-19 ICU patients in India, showing significantly lower mortality with PVP-I oral gargling and topical nasal use, and non-statistically significant higher mortality with ivermectin and lower mortality with remdesivir.

risk of death, 57.0% lower, RR 0.43, p < 0.001, treatment 39 of 163 (23.9%), control 62 of 103 (60.2%), NNT 2.8, adjusted, multivariable Cox regression.

Jamir et al., 12/13/2021, retrospective, India, South Asia, peer-reviewed, 6 authors, June 2020 - October 2020.

In Vivo Efficacy of Povidone-iodine Mouth Gargles in Reducing Salivary Viral Load in COVID-19 Patients: A Systematic Review

Sudhakar et al., World Journal of Dentistry, doi:10.5005/jp-journals-10015-1868 (Peer Reviewed) (meta analysis)

Systematic review of the use of povidone-iodine gargles for COVID-19, concluding that PVP-I effectively reduces SARS-CoV-2 viral load.

Sudhakar et al., 11/24/2021, peer-reviewed, 5 authors.

The Effect of Povidone-Iodine Nasal Spray on COVID-19 Nasopharyngeal Viral Load in Patients: A Randomized Control Trial

Zarabanda et al., Laryngoscope, doi:10.1002/lary.29935 (Peer Reviewed)

Very late treatment (7 days from onset) RCT comparing 11 & 13 PVP-I (0.5% and 2%), and 11 saline spray patients in the USA, showing no significant differences. There was no control group (saline is likely not a placebo, showing efficacy in other trials). There are large unadjusted differences between groups, e.g. 7.1 days from onset for PVP-I versus 4.8 for saline. Baseline Ct was higher for PVP-I, providing less room for improvement. Authors note that they cannot determine if earlier use is more beneficial.

risk of no recovery, 26.9% higher, RR 1.27, p = 1.00, treatment 3 of 13 (23.1%), control 2 of 11 (18.2%), 2%.

risk of no recovery, 50.0% higher, RR 1.50, p = 1.00, treatment 3 of 11 (27.3%), control 2 of 11 (18.2%), 0.5%.

risk of no virological cure, no change, RR 1.00, p = 1.00, treatment 2 of 7 (28.6%), control 2 of 7 (28.6%), day 5, minus strand PCR.

Zarabanda et al., 11/1/2021, Randomized Controlled Trial, USA, North America, peer-reviewed, 13 authors, this trial compares with another treatment - results may be better when compared to placebo.

Utilidad de los enjuagues con povidona yodada y peroxido de hidrogeno en pacientes con COVID-19

Pablo-Marcos et al., Enfermedades Infecciosas y Microbiología Clínica, doi:10.1016/j.eimc.2021.10.005 (Peer Reviewed)

Small prospective study with 31 patients gargling povidone-iodine, 17 hydrogen peroxide, and 40 control patients, showing lower viral load mid-recovery with povidone-iodine, without reaching statistical significance. Oropharyngeal only, and only every 8 hours for two days. Results may be better with the addition of nasopharyngeal use, more frequent use, and without the two day limit.

Authors are not familiar with the literature, having found only one of the 7 previous trials for PVP-I and COVID-19. Non-randomized study with no adjustments or group details. Some results in Figure 1 appear to be switched compared to the text and the labels in the figure. The viral clearance figures do not match the group sizes - for example authors report 62% PCR- for PVP-I at the 3rd test, however there is no number of 31 patients that rounds to 62%.

relative viral load, 29.2% better, RR 0.71, p = 0.40, treatment 31, control 40, 3rd PCR (mid-recovery).

relative viral load, 9.1% better, RR 0.91, p = 0.91, treatment 31, control 40, 4th PCR (most patients recovered).

Excluded in after exclusion results of meta analysis: unadjusted results with no group details.

Pablo-Marcos et al., 10/25/2021, prospective, Spain, Europe, peer-reviewed, 6 authors.

Tolerance of nasal and oral povidone-iodine antisepsis amid COVID-19 pandemic

Frank et al., Otolaryngology - Head and Neck Surgery, 165:89 (Preprint)

Prospective study of 42 otolaryngology and dental patients, showing low-dose nasal and oral PVP-I solutions to be well-tolerated.

Frank et al., 10/3/2021, preprint, 6 authors.

Rapid initiation of nasal saline irrigation: hospitalizations in COVID-19 patients randomized to alkalinization or povidone-iodine compared to a national dataset

Baxter et al., medRxiv, doi:10.1101/2021.08.16.21262044 (Preprint)

Small RCT 79 PCR+ patients 55+ comparing pressure-based nasal irrigation with povidone-iodine and sodium bicarbonate, showing improved recovery with povidone-iodine, and 0/37 COVID-19 related hospitalizations for povidone-iodine compared to 1/42 for sodium bicarbonate. NCT04559035.

risk of hospitalization, 65.3% lower, RR 0.35, p = 1.00, treatment 0 of 37 (0.0%), control 1 of 42 (2.4%), NNT 42, relative risk is not 0 because of continuity correction due to zero events.

risk of hospitalization/ER, 79.0% lower, RR 0.21, p = 0.50, treatment 0 of 37 (0.0%), control 2 of 42 (4.8%), NNT 21, relative risk is not 0 because of continuity correction due to zero events.

risk of no recovery, 56.8% lower, RR 0.43, p = 0.03, treatment 6 of 27 (22.2%), control 18 of 35 (51.4%), NNT 3.4.

risk of transmission, 36.9% lower, RR 0.63, p = 0.51, treatment 4 of 37 (10.8%), control 6 of 35 (17.1%), NNT 16.

risk of hospitalization, 94.1% lower, RR 0.06, p = 0.004, nasal irrigation vs. CDC data.

Baxter et al., 8/17/2021, Randomized Controlled Trial, USA, North America, preprint, 9 authors, this trial compares with another treatment - results may be better when compared to placebo.

Estimating salivary carriage of severe acute respiratory syndrome coronavirus 2 in nonsymptomatic people and efficacy of mouthrinse in reducing viral load

Chaudhary et al., The Journal of the American Dental Association, doi:10.1016/j.adaj.2021.05.021 (Peer Reviewed)

Small RCT comparing mouthrinsing with saline, 1% hydrogen peroxide, 0.12% chlorhexidine, and 0.5% povidone-iodine, showing significant reductions in salivary viral load for all 4 mouthrinses at 15 and 45 minutes after rinsing. NCT04603794.

Chaudhary et al., 6/11/2021, Randomized Controlled Trial, USA, North America, peer-reviewed, 17 authors.

Virucidal effect of povidone iodine on COVID-19 in the nasopharynx: an open-label randomized clinical trial

Arefin et al., Indian Journal of Otolaryngology and Head & Neck Surgery, doi:10.1007/s12070-021-02616-7 (Peer Reviewed)

RCT with 189 patients showing significantly greater viral clearance with a single application of PVP-I. Authors recommend using PVP-I prophylactically in the nasopharynx and oropharynx. NCT04549376 [1].

[1] trialsjournal.biomedcentral.com/articles/10.1186/s13063-020-04963-2

risk of no virological cure, 78.9% lower, RR 0.21, p = 0.02, treatment 4 of 27 (14.8%), control 19 of 27 (70.4%), NNT 1.8, 0.6% nasal irrigation.

risk of no virological cure, 89.5% lower, RR 0.11, p < 0.001, treatment 2 of 27 (7.4%), control 19 of 27 (70.4%), NNT 1.6, 0.5% nasal irrigation.

risk of no virological cure, 52.6% lower, RR 0.47, p = 0.006, treatment 9 of 27 (33.3%), control 19 of 27 (70.4%), NNT 2.7, 0.4% nasal irrigation.

risk of no virological cure, 80.0% lower, RR 0.20, p < 0.001, treatment 5 of 27 (18.5%), control 25 of 27 (92.6%), NNT 1.4, 0.6% nasal spray.

risk of no virological cure, 64.0% lower, RR 0.36, p < 0.001, treatment 9 of 27 (33.3%), control 25 of 27 (92.6%), NNT 1.7, 0.5% nasal spray.

risk of no virological cure, 73.6% lower, RR 0.26, p < 0.001, treatment 29 of 135 (21.5%), control 44 of 54 (81.5%), NNT 1.7, all treatment vs. all control.

Arefin et al., 5/18/2021, Randomized Controlled Trial, Bangladesh, South Asia, peer-reviewed, 9 authors.

Positive impact of oral hydroxychloroquine and povidone-iodine throat spray for COVID-19 prophylaxis: an open-label randomized trial

Seet et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2021.04.035 (Peer Reviewed)

Prophylaxis RCT in Singapore with 3,037 low risk patients, showing lower serious cases, lower symptomatic cases, and lower confirmed cases of COVID-19 with all treatments (ivermectin, HCQ, PVP-I, and Zinc + vitamin C) compared to vitamin C.

Meta-analysis of vitamin C in 6 previous trials shows a benefit of 16%, so the actual benefit of ivermectin, HCQ, and PVP-I may be higher. Cluster RCT with 40 clusters.

There were no hospitalizations and no deaths. NCT04446104.

risk of severe case, 44.7% lower, RR 0.55, p = 0.05, treatment 42 of 735 (5.7%), control 64 of 619 (10.3%), NNT 22.

risk of case, 31.1% lower, RR 0.69, p = 0.01, treatment 338 of 735 (46.0%), control 433 of 619 (70.0%), NNT 4.2, adjusted, OR converted to RR, model 6.

Seet et al., 4/14/2021, Cluster Randomized Controlled Trial, Singapore, Asia, peer-reviewed, 15 authors, this trial compares with another treatment - results may be better when compared to placebo.

Povidone Iodine (PVP-I) Oro-Nasal Spray: An Effective Shield for COVID-19 Protection for Health Care Worker (HCW), for all

Arefin, M., Indian Journal of Otolaryngology and Head & Neck Surgery, doi:10.1007/s12070-021-02525-9 (Peer Reviewed)

Report on clinical experience with prophylactic use of PVP-I for COVID-19 in a very high risk environment with no infections, review of the use of PVP-I for the prevention of respiratory infections, and recommendations for use with COVID-19.

Arefin et al., 4/8/2021, peer-reviewed, 1 author.

In vivo evaluation of the virucidal efficacy of chlorhexidine and povidone-iodine mouthwashes against salivary SARS-CoV-2. A randomized-controlled clinical trial

Elzein et al., Journal of Evidence Based Dental Practice, doi:10.1016/j.jebdp.2021.101584 (preprint 3/17) (Peer Reviewed)

Small RCT comparing mouthwashing with PVP-I, Chlorhexidine, and water, showing significant efficacy for both PVP-I and Chlorhexidine, with PVP-I increasing Ct by a mean of 4.45 (p < 0.0001) and Chlorhexidine by a mean of 5.69 (p < 0.0001), compared to no significant difference for water.

inverse relative improvement in Ct value, 88.8% lower, RR 0.11, p < 0.05, treatment 25, control 9.

Elzein et al., 3/17/2021, Double Blind Randomized Controlled Trial, Lebanon, Middle East, peer-reviewed, 7 authors.

Can povidone Iodine gargle/mouthrinse inactivate SARS-CoV-2 and decrease the risk of nosocomial and community transmission during the COVID-19 pandemic? An evidence-based update

Chopra et al., Japanese Dental Science Review, doi:10.1016/j.jdsr.2021.03.001 (Review) (Peer Reviewed)

Review discussing the rationale, safety, recommendations, and dosage of PVP-I gargle/mouthwash as an effective method to decrease the viral load of SARS-CoV-2.

Chopra et al., 3/15/2021, peer-reviewed, 5 authors.

Differential Effects of Antiseptic Mouth Rinses on SARS-CoV-2 Infectivity In Vitro

Xu et al., Pathogens, doi:10.3390/pathogens10030272 (Peer Reviewed) (In Vitro)

In Vitro study showing that PVP-I and other mouthwashes inactivated replication-competent SARS-CoV-2.

Xu et al., 3/1/2021, peer-reviewed, 7 authors.

In Vitro studies are an important part of preclinical research, however results may be very different in vivo.

Povidone iodine, hydrogen peroxide and chlorhexidine mouthwashes reduce SARS-CoV2 burden in whole mouth fluid and respiratory droplets

Jayaraman et al., medRxiv, doi:10.1101/2021.02.25.21252488 (Preprint)

Study of SARS-CoV2 burden in whole mouth fluid and respiratory droplets with povidone iodine, hydrogen peroxide, and chlorhexidine mouthwashes in 36 hospitalized COVID-19 patients using PCR and rapid antigen testing. There were significant reductions in SARS-CoV2 burden with all treatments in both respiratory droplets and whole mouth fluid.

Jayaraman et al., 3/1/2021, prospective, India, South Asia, preprint, 12 authors.

Povidone Iodine Mouthwash, Gargle, and Nasal Spray to Reduce Nasopharyngeal Viral Load in Patients With COVID-19: A Randomized Clinical Trial

Guenezan et al., JAMA Otolaryngol Head Neck Surg., doi:10.1001/jamaoto.2020.5490 (Peer Reviewed)

RCT of PCR+ patients with Ct<=20 with 12 treatment and 12 control patients, concluding that nasopharyngeal decolonization may reduce the carriage of infectious SARS-CoV-2 in adults with mild to moderate COVID-19. All patients but 1 had negative viral titer by day 3 (group not specified). There was no significant difference in viral RNA quantification over time. The mean relative difference in viral titers between baseline and day 1 was 75% [43%-95%] in the intervention group and 32% [10%-65%] in the control group. Thyroid dysfunction occurred in 42% of treated patients, with spontaneous resolution after the end of treatment. Patients in the treatment group were younger.

relative improvement in viral titer reduction between baseline and day 1, 63.2% better, RR 0.37, p = 0.25, treatment 12, control 12.

Guenezan et al., 2/4/2021, Randomized Controlled Trial, France, Europe, peer-reviewed, 7 authors.

In vitro inactivation of SARS-CoV-2 with 0.5% povidone iodine nasal spray (Nasodine) at clinically relevant concentrations and timeframes using tissue culture and PCR based assays

Tucker et al., bioRxiv, doi:10.1101/2021.01.31.426979 (Preprint) (In Vitro)

In Vitro study showing that PVP-I eliminated the viability of SARS-CoV-2 with short exposure times. Authors find that PCR alone may not be adequate for viral quantification and recommend incorporating cell culture to assess viral viability.

Tucker et al., 2/1/2021, preprint, 6 authors.

In Vitro studies are an important part of preclinical research, however results may be very different in vivo.

Tolerability and usability of 0.5% PVP-I gargles and nasal drops in 6692 patients: Observational study

Khan et al., American Journal of Otolaryngology, doi:10.1016/j.amjoto.2020.102880 (Peer Reviewed)

Study of the use of PVP-I gargles and nasal drops before and after ENT examinations with a total of 6,692 patients, finding high usability and good tolerance for use.

21 patients (0.76%) reported an itching sensation in the nose on the first day of use of 0.5% PVP-I nasal drops and discontinued its further use. However, none of the patients reported any serious side effects or allergic reaction to 0.5% PVP-I nasal drops and gargles.

The 0.5% PVP-I gargles and nasal drops were used by healthcare workers about three to four times in a day for 5 months. None of them developed any COVID-19 symptoms.

Khan et al., 1/3/2021, peer-reviewed, 2 authors.

Efficacy of commercial mouth-rinses on SARS-CoV-2 viral load in saliva: randomized control trial in Singapore

Seneviratne et al., Infection, doi:10.1007/s15010-020-01563-9 (Peer Reviewed)

Small mouthwash RCT with 4 PVP-I patients and 2 water patients concluding that PVP-I may have a sustained effect on reducing the salivary SARS-CoV-2 level in COVID-19 patients. ISRCTN95933274.

relative fold change, 32.9% better, RR 0.67, p < 0.01, treatment 4, control 2, PVP-I vs. water, 6 hours.

Seneviratne et al., 12/14/2020, Randomized Controlled Trial, Singapore, Asia, peer-reviewed, 12 authors.

Effect of 1% Povidone Iodine Mouthwash/Gargle, Nasal and Eye Drop in COVID-19 patient

Choudhury et al., Bioresearch Communications, Volume 7, Issue 1, January 2021 (Peer Reviewed)

RCT 606 patients in Bangladesh for povidone iodine mouthwash/gargle, nasal drops and eye drops showing significantly lower death, hospitalization, and PCR+ at day 7.

risk of death, 88.2% lower, RR 0.12, p < 0.001, treatment 2 of 303 (0.7%), control 17 of 303 (5.6%), NNT 20.

risk of hospitalization, 84.4% lower, RR 0.16, p < 0.001, treatment 12 of 303 (4.0%), control 77 of 303 (25.4%), NNT 4.7.

risk of no virological cure, 96.2% lower, RR 0.04, p < 0.001, treatment 8 of 303 (2.6%), control 213 of 303 (70.3%), NNT 1.5, day 7.

Choudhury et al., 12/3/2020, Randomized Controlled Trial, Bangladesh, South Asia, peer-reviewed, 6 authors.

Efficacy of Povidone-Iodine Nasal and Oral Antiseptic Preparations Against Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV-2)

Pelletier et al., Ear, Nose & Throat Journal, doi:10.1177/0145561320957237 (Peer Reviewed) (In Vitro)

In Vitro study testing nasal and oral PVP-I formulations with 60 second exposure time, showing complete inactivation of SARS-CoV-2 with all concentrations (1% to 5% PVP-I).

Pelletier et al., 9/21/2020, peer-reviewed, 6 authors.

In Vitro studies are an important part of preclinical research, however results may be very different in vivo.

In Vitro Efficacy of a Povidone-Iodine Nasal Antiseptic for Rapid Inactivation of SARS-CoV-2

Frank et al., JAMA Otolaryngol Head Neck Surg, doi:10.1001/jamaoto.2020.3053 (Peer Reviewed) (In Vitro)

In Vitro study showing povidone-iodine nasal antiseptics at concentrations (0.5%, 1.25%, and 2.5%) completely inactivated SARS-CoV-2 within 15 seconds of contact. No cytotoxic effects on cells were observed after contact with each of the nasal antiseptics tested.

Frank et al., 9/17/2020, peer-reviewed, 6 authors.

In Vitro studies are an important part of preclinical research, however results may be very different in vivo.

Early viral clearance among COVID-19 patients when gargling with povidone-iodine and essential oils: a pilot clinical trial

Mohamed et al., medRxiv, doi:10.1101/2020.09.07.20180448 (Preprint)

Tiny RCT with 5 PVP-I patients, gargling 30 seconds, 3x per day, and 5 control patients (essential oils and tap water were also tested), showing improved viral clearance with PVP-I.

risk of no virological cure, 85.7% lower, RR 0.14, p = 0.17, treatment 0 of 5 (0.0%), control 3 of 5 (60.0%), NNT 1.7, relative risk is not 0 because of continuity correction due to zero events, day 12.

Mohamed et al., 9/9/2020, Randomized Controlled Trial, Malaysia, Europe, preprint, 16 authors.

Povidone-Iodine Demonstrates Rapid In Vitro Virucidal Activity Against SARS-CoV-2, The Virus Causing COVID-19 Disease

Anderson et al., Infectious Diseases and Therapy, doi:10.1007/s40121-020-00316-3 (Peer Reviewed) (In Vitro)

In Vitro study showing rapid and effective virucidal activity of PVP-I
against SARS-CoV-2. All four products tested [antiseptic solution (PVP-I 10%), skin cleanser (PVP-I 7.5%), gargle and mouth wash (PVP-I 1%) and throat spray (PVP-I 0.45%)] achieved C 99.99% virucidal activity against SARS-CoV-2, corresponding to C 4 log10 reduction of virus titre, within 30s of contact.

Anderson et al., 7/8/2020, peer-reviewed, 8 authors.

In Vitro studies are an important part of preclinical research, however results may be very different in vivo.

Is povidone iodine mouthwash effective against SARS‐CoV‐2? First in vivo tests

Martínez Lamas et al., Oral Diseases, doi:doi.org/10.1111/odi.13526 (Peer Reviewed)

Small study analyzing the impact of PVP-I mouthwash on the salivary viral load of SARS-CoV-2 in 4 patients with COVID-19. In 2 of the 4 patients (those with a higher initial viral load), PVP-I resulted in a significant drop in viral load, which remained after 3 hours.

Martínez Lamas et al., 7/2/2020, peer-reviewed, 9 authors.

Povidone iodine gargle and mouthwash

Hassandarvish et al., British Dental Journal volume, doi:10.1038/s41415-020-1794-1 (Peer Reviewed) (In Vitro)

In Vitro study showing undiluted PVP-I (1% w/v) achieved >5 log10 reduction in SARS-CoV-2 virus titres at 15, 30 and 60 seconds treatment exposure under both clean and dirty conditions. In contrast, when PVP-I was tested at 1:2 dilution a >4 log10 kill at 15 seconds and >5 log10 kill at 30 and 60 seconds in comparison to control was seen in both clean and dirty conditions.

Hassandarvish et al., 6/26/2020, peer-reviewed, 8 authors.

In Vitro studies are an important part of preclinical research, however results may be very different in vivo.

Repurposing 0.5% povidone iodine solution in otorhinolaryngology practice in Covid 19 pandemic

Khan et al., Am J Otolaryngol, doi:10.1016/j.amjoto.2020.102618 (Peer Reviewed)

Study of the use of PVP-I gargles and nasal drops before ENT appointments finding good tolerability.

Khan et al., 6/18/2020, peer-reviewed, 3 authors.

Povidone-Iodine Use in Sinonasal and Oral Cavities: A Review of Safety in the COVID-19 Era

Frank et al., Ear, Nose & Throat Journal, doi:10.1177/0145561320932318 (Peer Reviewed)

Review of povidone-iodine finding that it can safely be used in the nose at concentrations up to 1.25% and in the mouth at concentrations up to 2.5% for up to 5 months.

Frank et al., 6/10/2020, peer-reviewed, 4 authors.

Rapid In-Vitro Inactivation of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Using Povidone-Iodine Oral Antiseptic Rinse

Bidra et al., Journal of Prosthodontics, doi:10.1111/jopr.13209 (Peer Reviewed) (In Vitro)

In Vitro study showing PVP-I rapidly inactivated SARS-CoV-2. Viricidal activity was present at the lowest concentration and contact time tested (0.5% PVP-I and 15 seconds).

Bidra et al., 6/8/2020, peer-reviewed, 6 authors.

In Vitro studies are an important part of preclinical research, however results may be very different in vivo.

Prevention of COVID-19 Infection with Povidone-Iodine

Mendoza et al., SSRN, doi:10.2139/ssrn.3589404 (Preprint)

Review of the antiviral efficacy of PVP-I and its potential use as a prophylactic on the oropharyngeal and nasopharyngeal mucosa for COVID-19.

Mendoza et al., 5/7/2020, preprint, 1 author.

Antiandrogens	(meta)	Metformin	(meta)
Aspirin	(meta)	Molnupiravir	(meta)
Bamlanivimab	(meta)	Nigella Sativa	(meta)
Bromhexine	(meta)	Nitazoxanide	(meta)
Budesonide	(meta)	Paxlovid	(meta)
Casirivimab/i..	(meta)	Povidone-Iod..	(meta)
Colchicine	(meta)	Probiotics	(meta)
Conv. Plasma	(meta)	Proxalutamide	(meta)
Curcumin	(meta)	Quercetin	(meta)
Favipiravir	(meta)	Remdesivir	(meta)
Fluvoxamine	(meta)	Sotrovimab	(meta)
Hydroxychlor..	(meta)	Vitamin A	(meta)
Iota-carragee..	(meta)	Vitamin C	(meta)
Ivermectin	(meta)	Vitamin D	(meta)
Melatonin	(meta)	Zinc	(meta)

Other Treatments		Global Adoption