Chlorine Dioxide As An Anti COVID-19 Oral Rinse
2

The world has seen many epidemics affecting the human race causing unpredictable disastrous situations, affecting human lives and economies around the world. Viral diseases which have no specific prevalence have to be dealt with utmost seriousness backed by academic literature and clinical research. COVID-19 is this type of non specific viral infection, which has created a panic situation globally because of lack of medical care in terms of proper drug selection to control the disease. There is an elaborate research going on in the field of pharmacology wherein several drugs have been undertaken to recognise their anti viral effects, thus there is a long wait for such specific drug to treat COVID-19.

Efforts Of Researchers In Finding Anti COVID-19 Drugs

Recently, drug hydroxy chloroquine was the talk of the world, as researchers of Western countries and WHO conducted lot of clinical trials on COVID-19 positive patients. They trusted this drug, thereby giving a message to the concerned population that this drug can be used as a precautionary measure to prevent COVID-19.

As this drug was used by healthcare professionals including dentists as a precautionary measure against COVID-19, they felt that this did not help to build any resistance against the disease. Thus, lot of health professionals raised concerns about the drug to be used as preventive measure against COVID-19. A lot of individuals had started to self-medicate with hydroxy chloroquine which led to serious side effects of the drug.

It costed the life of a dentist, who recently died following a cardiac arrest working on a patient. The cardiac arrest was linked to the drug’s side effect.

A recent Lancet study involving 96000 COVID-19 patients who were given hydroxychloroquine or chloroquine with other antibiotics presented with a higher death rate most commonly because of cardiac complications. However, this research was recently mired in controversy too. Nevertheless, researchers have warned the health professionals not to use this drug as an OTC product.

Recent studies have shown that Remdesivir has been widely used on COVID-19 positive patients and is approved by FDA in emergency cases. This drug is effectively used on severe COVID-19 patients with 200mg IV once on day 1, then 100mg IV once daily for 4 days. This drug follows the guidelines of National Institute of Health (NIH), Maryland, USA.

Lot of drugs have been tried and tested to treat COVID-19 like Anakinra, Azithromycin, Baricitiniv, Canakinumab, Chloroquine, Hydroxychloroquine, Lopinavir, Ritanavir, Remdesivir, Sarilumab, Situximab, Tocilizumab etc. Only by means of doing deep research and lots of trials, researchers can unravel this mystery of selecting a drug to treat COVID-19 patients. But right now Remdisivir has provided some hope against COVID-19 and needs to be researched further.

Chlorine Dioxide As An Anti COVID-19 drug

Aqueous solutions of chlorine dioxide (ClO2) have been effectively used as an antiviral preventive protocol in the form of an oral rinse since a long time. This aqueous ClO2 is capable to inactivate all type of viruses. Noss et al (1986) showed the actions of ClO2 on viral capsid proteins namely cysteine, tyrosine and tryptophan as they readily reacted with ClO2. Amino acids like histidine, hydroxyproline and proline showed much lesser reaction with ClO2 thereby not showing positive results. Ogata (2007) listed the antimicrobial activity of ClO2 mainly due to protein denaturation followed by oxidative modification of tyrosine and tryptophan.

It was a remarkable context as new corona virus SARS_CoV-2 showed spike proteins containing residues of tyrosine, tryptophan and cysteine. Lately it was shown that these residues were able to react with a dilute solution of chlorine oxide thereby inactivating the virus.

It is believed that chlorine dioxide can inactivate any type of virus in its gas phase. Most of the airborne viruses are destroyed by application of chlorine oxide under a low concentration in a gaseous phase thereby eliminating the airborne viruses. The US Occupational Safety Health Administration (OSHA) has given certain guidelines as per the concentration of ClO2 gas at workplace 0.1ppm (V/V) for 8hour exposure and 0.3ppm for 15min exposure.

In an aqueous medium too, ClO2 can inactivate viruses containing amino acids like tryptophan, tyrosine and cysteine. When aqueous ClO2 is sprayed in the room, it serves as an effective disinfectant too for all forms of microbes . Thus the combination of H2O and ClO2 molecules maintain the disinfected area for a longer time. The action of high concentrated ClO2 fastens the room disinfection procedures and it is widely used in hospitals, Intensive Care Units (ICUs), quarantine buildings and public transport vehicles.

ClO2 in the form of oral rinse can limit the droplet contamination thereby preventing the further spread of the disease if used carefully within the given dosage. We all know that human secretions shed lot of viruses, thereby becoming a means of droplet contamination. Secretions in the form of saliva are known to contain amino acids like cysteine, tyrosine and tryptophan residues which are readily destroyed by Clo2. Chlorine dioxide when used in an aqueous form like a mouth wash is much less toxic to human tissues compared to gaseous form and causes effective inactivation of all kinds of viruses. Hence, chlorine dioxide can be effectively and safely used as an anti COVID-19 oral rinse.

Read our special editorial on ‘Post Covid19 Dentistry’: Click here

References:

1. Hui DS, Azhar EI. The continuing 2019-nCoV epidemic threat of novel coronaviruses to global health. Int J Infect Dis 2020;91:264-6.

2. Hauchman FS, Noss CI. Chlorine dioxide reactivity with nucleic acids.Water Res 1986;20(3):357-61.

3. Lubbers JR, Chauhan SR. Controlled clinical evaluations of chlorine dioxide, chlorite and chlorate in man. Environ Health Perspect 1982;46:57-62.

4. Noszticzius Z, Wittmann M. Chlorine dioxide is a size-selective antimicrobial agent. PloS One 2013;8(11):e79157.

Dr Syed Ahmed Raheel
BDS, MDS. Reader and Incharge, HOD, Department of Oral Medicine. KGF college of dental sciences

    A Guide To Disinfection Of Face Shield While Maintaining Optical Clarity.

    Previous article

    Crossword puzzle – June

    Next article

    You may also like

    2 Comments

    1. Nice article compiled with detailed refrencing

    2. Thank you Dr. Your comments motivates us to write better and showcase best information for our dentists.

    Leave a reply

    Your email address will not be published. Required fields are marked *