Physiological serum, Rhinovirus and Sars-COV2

Use of Saline Solutions During COVID‑19: What Scientific Studies Reveal

When SARS‑COV2/COVID‑19 emerged in early 2020, the lack of knowledge about the virus led to numerous, often contradictory and sometimes scientifically inappropriate guidelines.
It is important to review the knowledge gained over the last two years, especially regarding the use of saline solution, nasopharyngeal lavage and nebulization practices.
A large number of studies worldwide have advanced understanding of saline use in rhinology.

Several relevant publications are summarized:

– A: Essentials in saline pharmacology for nasal or respiratory hygiene in times of Covid‑19 – European Journal of Pharmacology 2021 – https://doi.org/10.1007/s00228-021-03102-3
– B: Rapid initiation of nasal saline irrigation: hospitalizations in COVID‑19 patients randomized to alkalinization or povidone‑iodine – https://doi.org/10.1101/2021.08.16.21262044 (Department of Emergency Medicine, Augusta University, Georgia, USA – Preprint August 2021, Not peer reviewed)
– C: Nasopharyngeal and oropharyngeal rinses with neutral electrolyzed water prevent COVID‑19 in frontline health professionals – Biomedical Reports 16:11, 2022 – DOI: 10.3892/br.2021.1494
– D: Interim analysis of an open‑label randomized controlled trial evaluating nasal irrigations in non‑hospitalized COVID‑19 patients – Int Forum Allergy Rhinol. 2020; 10:1325–1328
– E: Nasal Irrigation in the COVID‑19 Era – International Journal of Clinical Studies & Medical Case Reports, September 2021 – DOI: 10.46998/IJCMCR.2021.13.000314

Conclusion

Because COVID‑19 was a new virus, the fear of the unknown and the absence of established knowledge initially led to precautionary measures aimed at preventing viral spread.
Long‑recognized hygiene practices — such as cleansing mucous membranes with saline solutions — were set aside mainly due to concerns about viral dissemination.
This perceived risk created a benefit‑risk ratio that did not appear favorable at the time. […]

– 1 – Pfeifer M, Ewig S, Voshaar T et al. (2020) Position paper for the state‑of‑the‑art application of respiratory support in patients with COVID‑19. Respiration 99:521–541. https://doi.org/10.1159/000509104
– 2 – Daviskas E, Anderson SD, Gonda I et al. (1996) Inhalation of hypertonic saline aerosol enhances mucociliary clearance in asthmatic and healthy subjects. Eur Respir J 9(4):725–732. https://doi.org/10.1183/09031936.96.09040725
– 3 – Fu Y, Tong J, Meng F et al. (2018) Ciliostasis of airway epithelial cells facilitates Influenza A virus infection. Vet Res 49(1):65. https://doi.org/10.1186/s13567-018-0568-0