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Povidone-Iodine COVID-19 studies. Some studies only test short term viral load after a single application. Excessive use of PVP-I could affect thyroid function. Recent:
Sevinç Gül
Submit updates/corrections.
Sep 30
Early, Late, PrEP, PEP Covid Analysis (Preprint) (meta analysis)
Povidone-Iodine for COVID-19: real-time meta analysis of 17 studies
Details   • Statistically significant improvements are seen for mortality, hospitalization, cases, and viral clearance. 8 studies from 8 independent teams in 6 different countries show statistically significant improvements in isolation (5 for the ..
Sep 8
Meta Hasan et al., European Journal of Dentistry, doi:10.1055/s-0042-1753470 (meta analysis)
Effects of Chlorhexidine and Povidone-Iodine on the SARS-CoV-2 Load: A Systematic Review and Meta-analysis
Details   Systematic review and meta analysis showing significantly improved viral clearance with both povidone-iodine and chlorhexidine.
Aug 22
Early Sirijatuphat et al., medRxiv, doi:10.1101/2022.08.18.22278340 (Preprint)
viral load, ↓33.3%, p=0.58
A pilot study of 0.4% povidone-iodine nasal spray to eradicate SARS-CoV-2 in the nasopharynx
Details   Small single-arm trial testing short-term viral load change after a single administration of three puffs of 0.4% PVP-I, showing lower viral titer at 3 minutes and 4 hours, not reaching statistical significance. Authors note that one reaso..
Jul 29
Early Natto et al., Medicine, doi:10.1097/MD.0000000000028925
viral load, ↓74.0%, p=0.27
The short-term effect of different chlorhexidine forms versus povidone iodine mouth rinse in minimizing the oral SARS-CoV-2 viral load: An open label randomized controlled clinical trial study
Details   60 patient RCT comparing chlorhexidine, PVP-I, and saline in Saudi Arabia with a single mouth rinse treatment and PCR testing 5 minutes later, showing statistically significant improvement in Ct value for PVP-I. PVP-I showed greater impro..
Jul 29
Early Sevinç Gül et al., Dental and Medical Problems, doi:10.17219/dmp/150831
viral load, ↓99.5%, p=0.37
Effect of oral antiseptics on the viral load of SARS-CoV-2: A randomized controlled trial
Details   RCT with 21 PVP-I and 20 saline patients gargling for 30 seconds and testing PCR Ct after 30 minutes, showing greater improvement with PVP-I, without statistical significance. Ct values differ across testing platforms, however the reporte..
Jul 28
Late Fantozzi et al., American Journal of Otolaryngology, doi:10.1016/j.amjoto.2022.103549
viral load, ↓57.5%
Efficacy of antiseptic mouthrinses against SARS-CoV-2: A prospective randomized placebo-controlled pilot study
Details   Mouthrinse RCT in Italy comparing short-term viral load after a single 60 second treatment with povidone-iodine, hydrogen peroxide, chlorhexidine, and saline. The greatest efficacy was seen with povidone-iodine, especially for patients wi..
Jul 27
Late Sánchez Barrueco et al., Emerging Microbes & Infections, doi:10.1080/22221751.2022.2098059
viral load, ↓33.9%
Effect of oral antiseptics in reducing SARS-CoV-2 infectivity: evidence from a randomized double-blind clinical trial
Details   RCT hospitalized patients testing viral load shortly after a single mouthwash with PVP-I, hydrogen peroxide, cetylpyridinium chloride, chlorhexidine, and water. For PVP-I, there were only 5 patients with viable virus at baseline. Cross-tr..
May 20
Review Lim et al., Annals of Medicine, doi:10.1080/07853890.2022.2076902 (Review)
Repurposing povidone-iodine to reduce the risk of SARS-CoV-2 infection and transmission: a narrative review
Details   Review of in vitro, animal, and clinical studies supporting the use of povidone-iodine for SARS-CoV-2.
Apr 19
Early Elsersy et al., Frontiers in Medicine, doi:10.3389/fmed.2022.863917
hosp., ↓90.9%, p=0.06
Combined Nasal, Oropharyngeal Povidone Iodine Plus Glycyrrhizic Acid Sprays, Accelerate Clinical and Laboratory Recovery and Reduces Household Transmission of SARS-CoV-2: A Randomized Placebo-Controlled Clinical Trial
Details   RCT with 200 patients and 421 contacts in Egypt, with 100 patients and their contacts treated with nasal and oropharyngeal sprays containing povidone-iodine and glycyrrhizic acid, showing significantly faster viral clearance and recovery,..
Feb 9
Early Friedland et al., Australian Journal of Otolaryngology, doi:10.21037/ajo-21-40 In vivo (human) and in vitro inactivation of SARS-CoV-2 with 0.5% povidone-iodine nasal spray
Details   Small study of povidone-iodine nasal spray with 14 patients, showing rapid reduction in viral load for the 6 patients that had culturable virus at baseline. All patients remained PCR+ despite no culturable virus detected for 3 of 6 patien..
Jan 15
Late Seikai et al., Journal of Hospital Infection, doi:10.1016/j.jhin.2022.01.001 Gargling with povidone iodine has a short-term inhibitory effect on SARS-Cov-2 in COVID-19 patients
Details   Small study of 11 patients showing a rapid short-term decrease of viral load in saliva samples with povidone-iodine.
Dec 22
Late Ferrer et al., Scientific Reports, doi:10.1038/s41598-021-03461-y
viral load, ↓34.0%, p=0.82
Clinical evaluation of antiseptic mouth rinses to reduce salivary load of SARS-CoV-2
Details   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 3..
Dec 13
Late Jamir et al., Cureus, doi:10.7759/cureus.20394
death, ↓57.0%, p=0.0004
Determinants of Outcome Among Critically Ill Police Personnel With COVID-19: A Retrospective Observational Study From Andhra Pradesh, India
Details   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.
Nov 24
Meta Sudhakar et al., World Journal of Dentistry, doi:10.5005/jp-journals-10015-1868 (meta analysis)
In Vivo Efficacy of Povidone-iodine Mouth Gargles in Reducing Salivary Viral Load in COVID-19 Patients: A Systematic Review
Details   Systematic review of the use of povidone-iodine gargles for COVID-19, concluding that PVP-I effectively reduces SARS-CoV-2 viral load.
Nov 1
Late Zarabanda et al., Laryngoscope, doi:10.1002/lary.29935
no recov., ↑26.9%, p=1.00
The Effect of Povidone-Iodine Nasal Spray on COVID-19 Nasopharyngeal Viral Load in Patients: A Randomized Control Trial
Details   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 i..
Oct 25
Early Pablo-Marcos et al., Enfermedades Infecciosas y Microbiología Clínica, doi:10.1016/j.eimc.2021.10.005
viral load, ↓29.2%, p=0.40
Utility of mouth rinses with povidone-iodine and hydrogen peroxide in patients with COVID-19
Details   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, a..
Oct 3
Safety Frank et al., Otolaryngology - Head and Neck Surgery, 165:89 (Preprint) Tolerance of nasal and oral povidone-iodine antisepsis amid COVID-19 pandemic
Details   Prospective study of 42 otolaryngology and dental patients, showing low-dose nasal and oral PVP-I solutions to be well-tolerated.
Aug 17
Early Baxter et al., medRxiv, doi:10.1101/2021.08.16.21262044 (Preprint)
hosp., ↓65.3%, p=1.00
Rapid initiation of nasal saline irrigation: hospitalizations in COVID-19 patients randomized to alkalinization or povidone-iodine compared to a national dataset
Details   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 ..
Jun 11
N/A Chaudhary et al., The Journal of the American Dental Association, doi:10.1016/j.adaj.2021.05.021 Estimating salivary carriage of severe acute respiratory syndrome coronavirus 2 in nonsymptomatic people and efficacy of mouthrinse in reducing viral load
Details   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.
May 18
Early Arefin et al., Indian Journal of Otolaryngology and Head & Neck Surgery, doi:10.1007/s12070-021-02616-7
viral+, ↓78.9%, p=0.02
Virucidal effect of povidone iodine on COVID-19 in the nasopharynx: an open-label randomized clinical trial
Details   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 .
Apr 14
PrEPPEP Seet et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2021.04.035
symp. case, ↓44.7%, p=0.002
Positive impact of oral hydroxychloroquine and povidone-iodine throat spray for COVID-19 prophylaxis: an open-label randomized trial
Details   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 ..
Apr 8
PrEPPEP Arefin, M., Indian Journal of Otolaryngology and Head & Neck Surgery, doi:10.1007/s12070-021-02525-9 Povidone Iodine (PVP-I) Oro-Nasal Spray: An Effective Shield for COVID-19 Protection for Health Care Worker (HCW), for all
Details   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-..
Mar 17
Early Elzein et al., Journal of Evidence Based Dental Practice, doi:10.1016/j.jebdp.2021.101584 (date from earlier preprint)
viral load, ↓88.8%, p<0.05
In vivo evaluation of the virucidal efficacy of chlorhexidine and povidone-iodine mouthwashes against salivary SARS-CoV-2. A randomized-controlled clinical trial
Details   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)..
Mar 15
Review Chopra et al., Japanese Dental Science Review, doi:10.1016/j.jdsr.2021.03.001 (Review)
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
Details   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.
Mar 1
In Vitro Xu et al., Pathogens, doi:10.3390/pathogens10030272 (In Vitro)
In Vitro
Differential Effects of Antiseptic Mouth Rinses on SARS-CoV-2 Infectivity In Vitro
Details   In Vitro study showing that PVP-I and other mouthwashes inactivated replication-competent SARS-CoV-2.
Mar 1
Early Jayaraman et al., medRxiv, doi:10.1101/2021.02.25.21252488 (Preprint) Povidone iodine, hydrogen peroxide and chlorhexidine mouthwashes reduce SARS-CoV2 burden in whole mouth fluid and respiratory droplets
Details   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 significan..
Feb 4
Early Guenezan et al., JAMA Otolaryngol Head Neck Surg., doi:10.1001/jamaoto.2020.5490
viral load, ↓63.2%, p=0.25
Povidone Iodine Mouthwash, Gargle, and Nasal Spray to Reduce Nasopharyngeal Viral Load in Patients With COVID-19: A Randomized Clinical Trial
Details   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 ne..
Feb 1
In Vitro Tucker et al., bioRxiv, doi:10.1101/2021.01.31.426979 (Preprint) (In Vitro)
In Vitro
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
Details   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.
Jan 3
Early Khan et al., American Journal of Otolaryngology, doi:10.1016/j.amjoto.2020.102880 Tolerability and usability of 0.5% PVP-I gargles and nasal drops in 6692 patients: Observational study
Details   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 fi..
Dec 14
Late Seneviratne et al., Infection, doi:10.1007/s15010-020-01563-9
viral load, ↓32.9%, p<0.01
Efficacy of commercial mouth-rinses on SARS-CoV-2 viral load in saliva: randomized control trial in Singapore
Details   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.
Dec 3
Early Choudhury et al., Bioresearch Communications, Volume 7, Issue 1, January 2021
death, ↓88.2%, p=0.0006
Effect of 1% Povidone Iodine Mouthwash/Gargle, Nasal and Eye Drop in COVID-19 patient
Details   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.
Sep 21
In Vitro Pelletier et al., Ear, Nose & Throat Journal, doi:10.1177/0145561320957237 (In Vitro)
In Vitro
Efficacy of Povidone-Iodine Nasal and Oral Antiseptic Preparations Against Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV-2)
Details   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).
Sep 17
In Vitro Frank et al., JAMA Otolaryngol Head Neck Surg, doi:10.1001/jamaoto.2020.3053 (In Vitro)
In Vitro
In Vitro Efficacy of a Povidone-Iodine Nasal Antiseptic for Rapid Inactivation of SARS-CoV-2
Details   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 ..
Sep 9
Early Mohamed et al., medRxiv, doi:10.1101/2020.09.07.20180448 (Preprint)
viral+, ↓85.7%, p=0.17
Early viral clearance among COVID-19 patients when gargling with povidone-iodine and essential oils: a pilot clinical trial
Details   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.
Jul 8
In Vitro Anderson et al., Infectious Diseases and Therapy, doi:10.1007/s40121-020-00316-3 (In Vitro)
In Vitro
Povidone-Iodine Demonstrates Rapid In Vitro Virucidal Activity Against SARS-CoV-2, The Virus Causing COVID-19 Disease
Details   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 0.4..
Jul 2
Early Martínez Lamas et al., Oral Diseases, Is povidone iodine mouthwash effective against SARS‐CoV‐2? First in vivo tests
Details   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,..
Jun 26
In Vitro Hassandarvish et al., British Dental Journal volume, doi:10.1038/s41415-020-1794-1 (In Vitro)
In Vitro
Povidone iodine gargle and mouthwash
Details   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..
Jun 18
Early Khan et al., Am J Otolaryngol, doi:10.1016/j.amjoto.2020.102618 Repurposing 0.5% povidone iodine solution in otorhinolaryngology practice in Covid 19 pandemic
Details   Study of the use of PVP-I gargles and nasal drops before ENT appointments finding good tolerability.
Jun 10
Safety Frank et al., Ear, Nose & Throat Journal, doi:10.1177/0145561320932318
safety analysis
Povidone-Iodine Use in Sinonasal and Oral Cavities: A Review of Safety in the COVID-19 Era
Details   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.
Jun 8
In Vitro Bidra et al., Journal of Prosthodontics, doi:10.1111/jopr.13209 (In Vitro)
In Vitro
Rapid In-Vitro Inactivation of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Using Povidone-Iodine Oral Antiseptic Rinse
Details   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).
Jun 5
Review O’Donnell et al., Function, doi:10.1093/function/zqaa002 (Review)
Potential Role of Oral Rinses Targeting the Viral Lipid Envelope in SARS-CoV-2 Infection
Details   Review of the mechanisms of action and studies supporting oral rinsing for the prevention of transmission of SARS-CoV-2, including chlorhexidine, cetylpyridinium chloride, hydrogen peroxide, and povidone-iodine.
May 7
PrEPPEP Mendoza et al., SSRN, doi:10.2139/ssrn.3589404 (Preprint) Prevention of COVID-19 Infection with Povidone-Iodine
Details   Review of the antiviral efficacy of PVP-I and its potential use as a prophylactic on the oropharyngeal and nasopharyngeal mucosa for COVID-19.
Please send us corrections, updates, or comments. Vaccines and treatments are both valuable and complementary. All practical, effective, and safe means should be used. No treatment, vaccine, or intervention is 100% available and effective for all current and future variants. Denying the efficacy of any method increases mortality, morbidity, collateral damage, and the risk of endemic status. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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