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      Antiviral mouthwashes: possible benefit for COVID-19 with evidence-based approach

      review-article
      a , b , c
      Journal of Oral Microbiology
      Taylor & Francis
      Mouthrinses, mouthwash, preprocedural, aerosols, chlorhexidine, C31G, PVP-I

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          ABSTRACT

          Background

          The outbreak, and pandemic of COVID-19 causing widespread concerns in all health systems of countries. Virus-carrying aerosols can penetrate the healthy human body and lungs, resulting in rapid transmission. For the first time, in this evidence-based article, the effects of different types of mouthwashes to reduce the viral load were investigated. Also, another aim of this essay is a reduction in viral load in patients with COVID-19 and prevention developing ventilator-associated pneumonia in critically ill patients.

          Methods

          Related databases were comprehensively searched for relevant studies. The present study was performed according to the preferred cases for standard systematic reviews (PRISMA).

          Results

          Five original studies in which the subject matter was directly evaluated were included. Different types of mouthwashes and viruses were investigated in this study.

          Conclusions

          The antiviral mouthwashes play a certainly important role in reducing the viral load of the salivary virus. In the present study, this importance could be proved in two different aspects, that is, the use of mouthwash before dental procedures to reduce the risk of transmission of the virus to the dental team and the use of this mouthwash in COVID-19 patients to help improve systemic problems associated with oral microbial flora.

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          Most cited references42

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          Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected Pneumonia

          Abstract Background The initial cases of novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) occurred in Wuhan, Hubei Province, China, in December 2019 and January 2020. We analyzed data on the first 425 confirmed cases in Wuhan to determine the epidemiologic characteristics of NCIP. Methods We collected information on demographic characteristics, exposure history, and illness timelines of laboratory-confirmed cases of NCIP that had been reported by January 22, 2020. We described characteristics of the cases and estimated the key epidemiologic time-delay distributions. In the early period of exponential growth, we estimated the epidemic doubling time and the basic reproductive number. Results Among the first 425 patients with confirmed NCIP, the median age was 59 years and 56% were male. The majority of cases (55%) with onset before January 1, 2020, were linked to the Huanan Seafood Wholesale Market, as compared with 8.6% of the subsequent cases. The mean incubation period was 5.2 days (95% confidence interval [CI], 4.1 to 7.0), with the 95th percentile of the distribution at 12.5 days. In its early stages, the epidemic doubled in size every 7.4 days. With a mean serial interval of 7.5 days (95% CI, 5.3 to 19), the basic reproductive number was estimated to be 2.2 (95% CI, 1.4 to 3.9). Conclusions On the basis of this information, there is evidence that human-to-human transmission has occurred among close contacts since the middle of December 2019. Considerable efforts to reduce transmission will be required to control outbreaks if similar dynamics apply elsewhere. Measures to prevent or reduce transmission should be implemented in populations at risk. (Funded by the Ministry of Science and Technology of China and others.)
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            Temporal dynamics in viral shedding and transmissibility of COVID-19

            We report temporal patterns of viral shedding in 94 patients with laboratory-confirmed COVID-19 and modeled COVID-19 infectiousness profiles from a separate sample of 77 infector-infectee transmission pairs. We observed the highest viral load in throat swabs at the time of symptom onset, and inferred that infectiousness peaked on or before symptom onset. We estimated that 44% (95% confidence interval, 25-69%) of secondary cases were infected during the index cases' presymptomatic stage, in settings with substantial household clustering, active case finding and quarantine outside the home. Disease control measures should be adjusted to account for probable substantial presymptomatic transmission.
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              Presumed Asymptomatic Carrier Transmission of COVID-19

              This study describes possible transmission of novel coronavirus disease 2019 (COVID-19) from an asymptomatic Wuhan resident to 5 family members in Anyang, a Chinese city in the neighboring province of Hubei.
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                Author and article information

                Journal
                J Oral Microbiol
                J Oral Microbiol
                Journal of Oral Microbiology
                Taylor & Francis
                2000-2297
                17 July 2020
                2020
                : 12
                : 1
                : 1794363
                Affiliations
                [a ]Dental Research Center, Dentistry Research Institute, Department of Oral Medicine, Faculty of Dentistry, Tehran University of Medical Sciences; , Tehran, Iran
                [b ]Oral and Maxillofacial Pathology Department, Pathology Department, School of Dentistry, Cancer Institute Hospital, IKHC, Tehran University of Medical Sciences; , Tehran, Iran
                [c ]School of Dentistry, Tehran University of Medical Sciences; , Tehran, Iran
                Author notes
                CONTACT Maryam Ansari mansari@ 123456student.tums.ac.ir School of Dentistry, Tehran University of Medical Sciences; , Tehran, Iran
                Article
                1794363
                10.1080/20002297.2020.1794363
                7482897
                32944152
                2e1e45c2-50cf-42c9-b123-5c56e73f4362
                © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Page count
                Figures: 0, Tables: 2, References: 51, Pages: 8
                Categories
                Review Article
                Review Article

                Microbiology & Virology
                mouthrinses,mouthwash,preprocedural,aerosols,chlorhexidine,c31g,pvp-i
                Microbiology & Virology
                mouthrinses, mouthwash, preprocedural, aerosols, chlorhexidine, c31g, pvp-i

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