Antivirals Effective Against Coronavirus?

[Hip]

@Hip do u have any info on the uk home antibody tests ? How effective they are, when they will be rolled out, how many people will get them, etc?

I've seen a few things in the papers, but have not been following the story closely. There appear to be a few companies rushing to create various coronavirus tests, and some PCR tests are already available, but they also have to be validated by medical authorities before they can be considered reliable.

 

[anne_likes_red]

The Use of Povidone Iodine Nasal Spray and Mouthwash During the Current COVID-19 Pandemic May Protect Healthcare Workers and Reduce Cross Infection.

7 Pages Posted: 30 Mar 2020


Justin Kirk-Bayley
Royal Surrey County Hospital
Stephen Challacombe
King's College London
San Sunkaraneni
Royal Surrey County Hospital
James Combes
Defence Medical Services



https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3563092

It's easy to download the paper (nb it's still under review) and the recommendations for use of povidone-iodine are very clear.

 

[junkcrap50]

The Use of Povidone Iodine Nasal Spray and Mouthwash During the Current COVID-19 Pandemic May Protect Healthcare Workers and Reduce Cross Infection.
7 Pages Posted: 30 Mar 2020
....
https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3563092

Bravo @Hip for being the first to uncover and think of this!

 

[Hip]

Bravo @Hip for being the first to uncover and think of this!

I initially suggested (in this post) that povidone-iodine could be used as a persistent hand sanitizer disinfectant that may continue to destroy any new viral contamination the hands pick up for several hours after application (whereas alcohol only kills viruses at the time of application).

But it was @Cipher who did some further investigation, and found some interesting studies demonstrating that povidone-iodine gargling has antiviral effects which may help prevent catching viral infection (see his post here).

So bravo to @Cipher!

 

[anne_likes_red]

The paper mentions a product commonly available in the UK and licensed for oral mucosal use - Videne, Antiseptic solution Povidone-iodine 10% w/w 10%. (Antiseptic Cleanser for Skin and Mucous Membranes. ECOLAB Ltd.)

I noticed Betadine products are measured w/v instead of w/w. I have a mouthwash solution @ 7.5% w/v and an antiseptic solution @10% w/v.
..@Hip do you (or does anyone else) know how the products Videne and Betadine - the 10% solutions - are likely to compare?
Anne.

 

[Hip]

I noticed Betadine products are measured w/v instead of w/w. I have a mouthwash solution @ 7.5% w/v and an antiseptic solution @10% w/v.
..@Hip do you (or does anyone else) know how the products Videne and Betadine - the 10% solutions - are likely to compare?

I think weight/volume and the weight/weight will be the same in this case, because for water, 1 ml in volume is equal to 1 gram in weight.

A 10% w/v solution of povidone-iodine means for every 100 ml of water you have 10 grams of povidone-iodine.

A 10% w/w solution of povidone-iodine means for every 100 grams of water you have 10 grams of povidone-iodine.

So 10% w/v = 10% w/w for povidone-iodine in aqueous solution.

 

[Hip]

https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3563092

It's easy to download the paper (nb it's still under review) and the recommendations for use of povidone-iodine are very clear.

Looks like the paper recommends a 0.5% solution povidone-iodine for use as an oral gargle and nasal spray:

In the hospital setting, we propose that a 0·5% (5 mg/ml) PVP-I solution be applied to the oral, oropharyngeal and nasopharyngeal mucosa of patients with presumed/confirmed COVID-19 and the healthcare personnel in close contact with this cohort. At these concentrations antiviral activity is still optimal and lasting staining of skin, mucous membranes and teeth is minimal and reversible.

You would have to dilute the 10% solution by 20:1 to get a 0.5% solution, which makes using povidone-iodine quite economical.

For the nasal spray, they recommend 0.3 ml of the 0.5% povidone-iodine solution to be sprayed into each nostril. Pump action nasal spray bottles typically deliver 0.1 ml per spray, so 0.3 ml would be 3 sprays.

They suggest the antiviral protective effect of this 0.5% povidone-iodine solution applied to the mucous membranes would last for 3 hours.



Very useful study, a great find, @anne_likes_red.

 

[Hip]

I notice that Videne povidone-iodine product is available as an aqueous solution, an alcohol tincture, and a surgical scrub:

Alcoholic Tincture
Povidone-iodine 10% w/w.
Premium anti-microbial skin disinfectant with a rapid drying formulation.

Antiseptic Solution
10% w/w iodinated povidone.
premium anti-microbial skin, mucosal and wound disinfectant.

Surgical Scrub
Povidone-Iodine 7.5% w/w cutaneous solution.
A premium anti-microbial hand and skin disinfectant with added emollients.

Source: here

I think the alcohol formulation would not work for a nasal spray, as the alcohol might be painful in the nose. So the Videne Antiseptic Solution seems like the appropriate choice for gargling and nasal spray use.

 

[anne_likes_red]

In Canada, Aus and NZ an equivalent product is labelled "Betadine Antiseptic Solution, Povidone-iodine 10% w/v."
I got a 500 ml bottle, from an online chemist, for around 15 NZ dollars.

 

[Gemini]

I am not sure if this guide from John Hopkins has been posted elsewhere, but it is filled with info. about the virus. Posting it here for the drug info..(antivirals* and immunomodulators), but it is worth reviewing the whole document if you are interested in a fairly comprehensive overview of info. about the virus. SARS_CoV_2_

Thanks @Wally good information.

"Race to Find COVID-19 Treatments Accelerates," 3/27/2020 (Science), features this diagram illustrating
lines of attack:

 

[Gemini]

"Race to Find COVID-19 Treatments Accelerates," 3/27/2020 (Science)

The article describes the WHO megatrial, SOLIDARITY, with tens of thousands of COVID-19 patients in dozens of countries given 1 of 4 experimental treatments depending on availability at their hospital: remdesivir, chloroquine/hydroxychloroquine, lopinavir/ritonavir, and the latter combination plus interferon-beta.

For simplicity and speed physicians will merely record when the patient left the hospital or died; duration of the stay; and whether they required oxygen or ventilation.

The design is not blinded, patients will know they received a drug which could cause a placebo effect WHO acknowledges. It could provide quick information based on outcomes most useful for public health it's felt.

@Hip

 

[Hip]

For anyone considering povidone-iodine nasal sprays and oral gargling/mouthwash as protection against contracting coronavirus, I just came across this article:

In the United States, povidone-iodine solutions are sold as skin disinfectants, which contain ingredients that can cause serious harm if ingested; preparations that are suitable for gargling are not generally available in this country. It’s critical that people not gargle with skin disinfectant solutions, including those that contain povidone-iodine. In Canada, a povidone-iodine gargle solution is sold under the brand name Betadine.

I could not find the names of those toxic ingredients; but if anyone is planning to gargle povidone-iodine you might want to ensure that the product you buy is intended for gargling as well as skin use.

@anne_likes_red @junkcrap50

 

[Hipsman]

I could not find the names of those toxic ingredients; but if anyone is planning to gargle povidone-iodine you might want to ensure that the product you buy is intended for gargling as well as skin use.

Thank you for this information. I was using local product named Betadine, but instruction only mentions usage for skin and wounds. It contains: Glycerol, Nonoxynol-9, Citric acid, Disodium phosphate, Sodium hydroxide.
Except for Nonoxynol-9, all of them appear to be safe since they are used in foods.

From wikipedia it appears that Nonoxynol-9 has some unwanted side-effects if used long-term, so I will have to find other brand if I want to use this for more than few weeks.

 

[anne_likes_red]

https://www.nycdentist.com/blog/cv/ is an article that discusses the paper.protocol I posted earlier.
The author mentions that Betadine 10% solution contains trace amounts of Pareth 25-9 and sodium hydroxide and they may cause allergic reactions in some people. He suggests diluting and using a "generic" bottle of povidone-iodine 10% instead.
Presumably the Betadine 7.5% formulation sold for use as throat gargle is just fine. It doesn't foam like the Betadine Antiseptic Solution.
Ever tried gargling something that foams into big bubbles? Makes that Bulletproof sinus rinse feel like a walk in the park...

 

[Celandine]

This looks interesting--https://www.medscape.com/viewarticle/928152?nlid=134891_3901&src=wnl_newsalrt_200405_MSCPEDIT&uac=342943MX&impID=2336269&faf=1

Tocilizumab was the magic bullet for this Italian doctor

 

[junkcrap50]

Presumably the Betadine 7.5% formulation sold for use as throat gargle is just fine. It doesn't foam like the Betadine Antiseptic Solution.
Ever tried gargling something that foams into big bubbles? Makes that Bulletproof sinus rinse feel like a walk in the park...

Lol that's good to know about the oral rinse not causing bubbles. That was a problem I had with my iodine (and it was NOT the scrub form/product).

 

[Cipher]

Mundipharma, the company behind Betadine, have a product in Germany called Betaisodona Mund-Antiseptikum. I've found a German pharmacy that sends abroad here. Alternative pharmacies can be found on this site. The product information says that you're supposed to dilute it 1 part concentrate (7,5%) + 4 parts water (=1,5% PVP-I), but I think 6 parts water will do just fine (=1.1% PVP-I).

@Hip @Hipsman @junkcrap50

 

[Hip]

On the UK Amazon for £18, I just bought a 500 ml bottle of Videne Antiseptic Solution, which is 10% povidone-iodine, and is formulated for mucous membrane use as well as skin use, so I think should be fine for gargling and nasal application. Thanks to @anne_likes_red for finding this Videne product.

The Videne manufacturer's page says:

a broad range of indications - skin, mucous membrane and wound antisepsis

The pdf document on that page says:

Contraindications: Videne must not be used in hyperthyroidism or other manifest thyroid diseases

Whether it is safe for hypothyroidism is not clear.

 

[Wally]

https://www.sciencedaily.com/releases/2020/04/200413144055.htm

Study finds remdesivir effective against a key enzyme of coronavirus that causes COVID-19

Date:​

April 13, 2020​

Source:​

University of Alberta Faculty of Medicine & Dentistry​

Summary:​

Scientists have shown that the drug remdesivir is highly effective in stopping the replication mechanism of the coronavirus that causes COVID-19. The finding follows closely on research demonstrating how the drug worked against the Middle East Respiratory Syndrome (MERS) virus, a related coronavirus.​

 

[Wally]

Linking to another thread that provides an update, as of 4/17/2020, from Dr. Francis Collins, NIH Director, re research for the drug Remdesivir, as a possible anti-viral treatment for COVID-19. https://forums.phoenixrising.me/threads/nih-status-of-remdesivir-an-anti-viral-for-covid-19.79824/

Thanks to @Gemini for finding this update.