Effectiveness of mouth rinses against COVID-19: a systematic review and network meta-analysis

source extracted confidence: high 2026-04-09
#humans #covid-19 #mouthwashes #povidone-iodine #sars-cov-2

Effectiveness of mouth rinses against COVID-19: a systematic review and network meta-analysis

Lin et al., 2023 | J Hosp Infect | Systematic Review

Citation

Lin S-Y, Sun J-S, ... Chang J Z-C. Effectiveness of mouth rinses against COVID-19: a systematic review and network meta-analysis. J Hosp Infect. 2023-Sep;139:175-191. doi:10.1016/j.jhin.2023.06.022

Abstract

OBJECTIVE: This systematic review and network meta-analysis (NMA) comprehensively compared the effectiveness of different mouth rinses in reducing the viral load/infectivity of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) (Part I), alleviating clinical symptoms or severity of disease (Part II), and decreasing the incidence of SARS-CoV-2 infection (Part III). METHODS: Randomized controlled trials (RCTs) and non-randomized controlled trials (NRCTs) with restrictions were searched up to 3rd March 2023. Twenty-three studies (22 RCTs and one NRCT) met the inclusion criteria for this systematic review. RESULTS: Five RCTs (454 patients and nine interventions) in Part I were eligible for NMA. The NMA results showed that, in comparison with no rinse, sodium chloride (NaCl) was the most effective mouth rinse for reducing the viral load, followed by povidone-iodine (PVP-I), ß-cyclodextrin + citrox (CDCM), hydrogen peroxide (HP), chlorhexidine gluconate (CHX), cetylpyridinium chloride (CPC), placebo and hypochlorous acid (HClO). However, these results were not significant. Based on surface under the cumulative ranking curve scores, PVP-I was likely to be the most efficacious mouth rinse for reducing SARS-CoV-2 viral load, followed by CDCM, HP, NaCl, CHX, CPC, placebo, no rinse and HClO. CONCLUSION: Due to heterogeneity of the primary studies, the effectiveness of different mouth rinses to reduce viral infectivity, improve clinical symptoms or prevent SARS-CoV-2 infection remains inconclusive.

Key Findings

Five RCTs (454 patients and nine interventions) in Part I were eligible for NMA. The NMA results showed that, in comparison with no rinse, sodium chloride (NaCl) was the most effective mouth rinse for reducing the viral load, followed by povidone-iodine (PVP-I), ß-cyclodextrin + citrox (CDCM), hydrogen peroxide (HP), chlorhexidine gluconate (CHX), cetylpyridinium chloride (CPC), placebo and hypochlorous acid (HClO). However, these results were not significant. Based on surface under the cumulati

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size 454
Age Range See abstract
Condition See abstract

MeSH Terms

  • Humans
  • COVID-19
  • Mouthwashes
  • Povidone-Iodine
  • SARS-CoV-2
  • Sodium Chloride
  • Hydrogen Peroxide
  • Mouth

Evidence Classification

  • Level: Systematic Review
  • Publication Types: Systematic Review, Journal Article, Network Meta-Analysis
  • Vertical: iodine

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09