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

IF 17.7 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2024-06-01 Epub Date: 2022-08-25 DOI:10.1177/01455613221123737

Amy L Baxter, Kyle R Schwartz, Ryan W Johnson, Ann-Marie Kuchinski, Kevin M Swartout, Arni S R Srinivasa Rao, Robert W Gibson, Erica Cherian, Taylor Giller, Houlton Boomer, Matthew Lyon, Richard Schwartz

{"title":"Rapid initiation of nasal saline irrigation to reduce severity in high-risk COVID+ outpatients.","authors":"Amy L Baxter, Kyle R Schwartz, Ryan W Johnson, Ann-Marie Kuchinski, Kevin M Swartout, Arni S R Srinivasa Rao, Robert W Gibson, Erica Cherian, Taylor Giller, Houlton Boomer, Matthew Lyon, Richard Schwartz","doi":"10.1177/01455613221123737","DOIUrl":null,"url":null,"abstract":"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 (X2 = 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.","PeriodicalId":1,"journal":{"name":"Accounts of Chemical Research","volume":" ","pages":"30S-39S"},"PeriodicalIF":17.7000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Accounts of Chemical Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/01455613221123737","RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/8/25 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"CHEMISTRY, MULTIDISCIPLINARY","Score":null,"Total":0}

引用次数: 0

Abstract

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 (X² = 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.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

快速启动鼻腔生理盐水冲洗，降低 COVID+ 高危门诊患者的病情严重程度。

目的与观察对照组相比，确定 COVID-19 诊断后开始生理盐水鼻腔冲洗是否会减少高风险门诊患者的住院和死亡，以及冲洗液成分是否会影响严重程度：在 2020 年 9 月 24 日至 12 月 21 日期间，55 岁及以上的参与者在 + PCR COVID-19 检测后 24 小时内进行了登记。在筛选出的 826 名参与者中，有 79 名参与者入选并被随机分配到在 240 mL 等渗鼻腔冲洗液中添加 2.5 mL 10%聚维酮碘或 2.5 mL 碳酸氢钠，每天两次，持续 14 天。主要结果是在入组 28 天内因 COVID-19 住院或死亡，每天通过电话和医院记录确认自我报告，并与同期的疾病预防控制中心监测数据集进行比较。次要结果是比较不同冲洗剂添加剂的症状缓解情况：79名高风险参与者（平均[标码]年龄为64[8]岁；36[46%]名女性；71%为非西班牙裔白人）加入了研究，平均体重指数为30.3。根据意向治疗分析，到第 28 天，COVID-19 症状导致 42 人接受碱化灌洗，其中 1 人到急诊室就诊，没有人住院；37 人接受聚维酮碘治疗，其中 1 人住院（1.27%），没有人死亡。在近 300 万 CDC 病例中，已知有 9.47% 的病例曾住院治疗，在没有住院治疗数据的病例中，另有 1.5% 的病例死亡。通过精确二项检验，年龄、性别和原有病症比例与疾病预防控制中心数据集没有显著差异，而报告的种族和住院率则有显著差异。住院或死亡的总风险（11%）是鼻腔灌洗参与者的 8.57 倍（SE = 2.74；P = .006）。62 名参与者完成了每日调查（78%），平均每天灌洗 1.8 次。11 人报告了与灌洗有关的不适，4 人停止使用。报告每日灌洗两次的参与者更容易缓解症状（X2 = 8.728，P = .0031），与添加剂无关：结论：SARS-CoV-2+患者开始鼻腔冲洗后住院的几率是全国住院率的 8 倍多。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.