Rapid initiation of nasal saline irrigation to reduce severity in high-risk COVID+ outpatients.

Autor:	Baxter AL; Department of Emergency Medicine, Augusta University, Augusta, GA, USA., Schwartz KR; Edinburgh Napier University, Edinburgh, UK., Johnson RW; Medical College of Georgia, Augusta University, Augusta, GA, USA., Kuchinski AM; Department of Emergency Medicine, Augusta University, Augusta, GA, USA., Swartout KM; Department of Psychology, Georgia State University, Atlanta, GA, USA., Srinivasa Rao ASR; Laboratory for Theory and Mathematical Modeling, Department of Medicine-Division of Infectious Diseases, Medical College of Georgia, Augusta University, Augusta, GA, USA.; Department of Mathematics, Augusta University, Augusta, GA, USA., Gibson RW; Department of Emergency Medicine, Augusta University, Augusta, GA, USA., Cherian E; Medical College of Georgia, Augusta University, Augusta, GA, USA., Giller T; Medical College of Georgia, Augusta University, Augusta, GA, USA., Boomer H; Department of Emergency Medicine, Augusta University, Augusta, GA, USA., Lyon M; Department of Emergency Medicine, Augusta University, Augusta, GA, USA., Schwartz R; Department of Emergency Medicine, Augusta University, Augusta, GA, USA.
Jazyk:	angličtina
Zdroj:	Ear, nose, & throat journal [Ear Nose Throat J] 2024 Jun; Vol. 103 (1_suppl), pp. 30S-39S. Date of Electronic Publication: 2022 Aug 25.
DOI:	10.1177/01455613221123737
Abstrakt:	Objective: To determine whether initiating saline nasal irrigation after COVID-19 diagnosis reduces hospitalization and death in high-risk outpatients compared with observational controls, and if irrigant composition impacts severity. Methods: Participants 55 and older were enrolled within 24 hours of a + PCR COVID-19 test between September 24 and December 21, 2020. Among 826 screened, 79 participants were enrolled and randomly assigned to add 2.5 mL povidone-iodine 10% or 2.5 mL sodium bicarbonate to 240 mL of isotonic nasal irrigation twice daily for 14 days. The primary outcome was hospitalization or death from COVID-19 within 28 days of enrollment by daily self-report confirmed with phone calls and hospital records, compared to the CDC Surveillance Dataset covering the same time. Secondary outcomes compared symptom resolution by irrigant additive. Results: Seventy-nine high-risk participants were enrolled (mean [SD] age, 64 [8] years; 36 [46%] women; 71% Non-Hispanic White), with mean BMI 30.3. Analyzed by intention-to-treat, by day 28, COVID-19 symptoms resulted in one ED visit and no hospitalizations in 42 irrigating with alkalinization, one hospitalization of 37 in the povidone-iodine group, (1.27%) and no deaths. Of nearly three million CDC cases, 9.47% were known to be hospitalized, with an additional 1.5% mortality in those without hospitalization data. Age, sex, and percentage with pre-existing conditions did not significantly differ by exact binomial test from the CDC dataset, while reported race and hospitalization rate did. The total risk of hospitalization or death (11%) was 8.57 times that of enrolled nasal irrigation participants (SE = 2.74; P = .006). Sixty-two participants completed daily surveys (78%), averaging 1.8 irrigations/day. Eleven reported irrigation-related complaints and four discontinued use. Symptom resolution was more likely for those reporting twice daily irrigation ( X 2 = 8.728, P = .0031) regardless of additive. Conclusion: SARS-CoV-2+ participants initiating nasal irrigation were over 8 times less likely to be hospitalized than the national rate. Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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