Vitiello, A., Ferrara, F., Troiano, V. & La Porta, R. COVID-19 vaccines and decreased transmission of SARS-CoV-2. Viruses 13, 895. https://doi.org/10.3390/v13050895 (2021). Get the most important science stories of the day, free in your inbox. Moreover, this group showed that azelastine has the potential to inhibit SARS-CoV-2 cell entry by binding to the angiotensin-converting enzyme 2 (ACE2) receptor and to inhibit intracellular virus replication through binding to the sigma-1 receptor6. Ghahremanpour et al. Google Scholar. The researchers picked four compounds that worked at very low concentrations and did not negatively affect the host cells. The researchers first tried one dose a day for seven days, starting a day before SARS-CoV-2 infection. New research has answers, COVID's future: mini-waves rather than seasonal surges, Are repeat COVID infections dangerous? The aim of our study was to support the preclinical evidence for azelastines antiviral activity in patients tested positive for SARS-CoV-2. reported that a low pH hypromellose nasal powder spray containing common components of nasal sprays could reduce SARS-CoV-2 infection rates19. Analyses were done on the entire data set (ITT) as well as on a subset population with high viral load defined by baseline Ct values below 25 (Ct<25). The viral load reduction of the ORF 1a/b gene from baseline to day 11 was log10 5.042.05 in the 0.1% azelastine group, log10 4.391.74 in the 0.02% azelastine and log10 4.151.34 in the placebo group. Data on virus variants was available for 59 patients and 54 (92%) of those carried the alpha (B.1.1.7) variant. J.P.K. Article Following sampling, swabs were placed into 3mL Virus Transport Medium (VTM, Biocomma) and delivered to the laboratory as quickly as possible. The spritz developed by Moscona's team is one of a raft of proposed nasal sprays to prevent SARS-CoV-2 infection. 384, 671673. Of note, pharmacometric analyses of our data indicate that more frequent applications of the nasal spray may be more appropriate for efficient treatment35. Smell Retraining Therapy. The number of possibly and probably related adverse events was comparable between treatment groups (supplementary Table S6), and no safety concerns regarding the treatment regime were raised. Ralph Msges. Boots Dual Defence Nasal Spray Family Bundle - 4 x 20ml Boots Dual Defence Nasal Spray Family Bundle - 4 x 20ml 20.00 Save 3.96 Worth 23.96 when bought separately 1486004 Maximum quantity reached Add to basket Add to favourites Collect 80 Boots Advantage Card points with this purchase Product details In this bundle: identified azelastine as an anti-viral candidate and demonstrated pronounced anti-SARS-CoV-2 activity in vitro10. By submitting a comment you agree to abide by our Terms and Community Guidelines. Patients were visited and tested at home on regular basis by the investigators, physicians specialised in otorhinolaryngology, medical hygiene, or general medicine. What scientists say. Identification of SARS-CoV-2 entry inhibitors among already approved drugs. Nasal antiviral blocks SARS-CoV-2 infection in mice, Finding Effective Treatments for SARS-CoV-2 Variants, Understanding the Range of Reactions to SARS-CoV-2, Lee, K. (2022, April 27). It's being studied as a potential way to prevent mild to moderate cases of COVID-19. Since viral levels during early infection with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) tend to be highest in the nose and nasopharynx 1, a nasal spray with an active substance . Patients aged 18 to 60years were eligible to participate if tested positive for SARS-CoV-2 in a Corona test centre by PCR test within 48h prior to inclusion and had to quarantine at home due to instructions of the local health authority. 15, 75297536. A TMPRSS2 inhibitor acts as a pan-SARS-CoV-2 prophylactic and therapeutic. Rep. 12, 899. https://doi.org/10.1038/s41598-021-04573-1 (2022). Researchers are developing coronavirus vaccines that will be sprayed up the nose. performed and supervised sample processing and viral load measurements. De Vries, R. D. et al. Google Scholar. Thus, eligibility criteria were designed carefully to investigate a clearly defined, homogeneous study population of low-risk patients with a narrow age range. Absolute changes in viral copy numbers (log10 cp/mL) from baseline (day 1) over time based on the ORF 1a/b gene (ITT analysis set). We are aware that this limited the capture of COVID-19 specific issues as questions were not specifically aimed for COVID-19 patients. While PCR results in the placebo group turned negative only on day 11 of treatment, individual patients of the 0.1% azelastine group already showed negative PCR test results from day 2 on. Those parameters were based on the COVID-19 symptoms published by the Robert Koch Institute (https://www.rki.de) at the time of the study. Slider with three articles shown per slide. Pawar, R. D. et al. Winchester, S., John, S., Jabbar, K. & John, I. And she wished she could feel confident that she could see her immunocompromised relatives without inadvertently spreading the novel coronavirus to them. The primary endpoint of the CARVIN study was the assessment of virus load kinetics of SARS-CoV-2 by determining the presence and amount of viral carriage via PCR. A TMPRSS2 inhibitor acts as a pan-SARS-CoV-2 prophylactic and therapeutic. Because we get infected with SARS-CoV-2 primarily by breathing it in, a nasal spray might be an easy and efficient way to offer protection against the virus, especially in crowded places. A nasal and mouth spray called "IGM-6268" is in the early stages of clinical trials. Nasal defence sprays Products such as Vicks First Defence nasal spray claim to trap and neutralise viruses in the nose before they have a chance to develop and spread. was the deputy investigator. Researchers have looked for ways to prevent SARS-CoV-2 infection that the virus cant learn to dodge or evade by mutating. Mutations in spike allow the virus to evade the immune system as well as therapies designed to target it. Only one of the 20 mice given saline survived. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. Viral load and disease severity in COVID-19. Ctcycle threshold. Povidone iodine mouthwash, gargle, and nasal spray to reduce nasopharyngeal viral load in patients with COVID-19: A randomized clinical trial. Nat. Study endpoints were presented by descriptive statistics, aiming to compare the course of viral load between the three treatment groups. Quantifying the relationship between SARS-CoV-2 viral load and infectiousness. In a study funded by NIAID, researchers are using mice to look for genes that account for different COVID-19 symptoms. Resource-efficient internally controlled in-house real-time PCR detection of SARS-CoV-2. Importantly, this scenario corresponds to current COVID-19 treatment regimens (e.g., with monoclonal antibodies or antiviral substances), which are usually started at57days upon start of symptoms but are still efficacious. 62, 50937, Cologne, Germany, You can also search for this author in The current proof-of-concept study served to investigate if nasally applied azelastine may have the potential to reduce the viral load (via blocking viral entry and viral replication) in patients tested positively for SARS-CoV-2. A summary of study activities is displayed in Table 2. https://doi.org/10.1056/NEJMc2027040 (2021). The higher viral load value may be explained with the dominance of the alpha (B.1.1.7) SARS-CoV-2 variant during the enrolment phase (Spring 2021, Germany16), which is known to infect the human nasal mucosa more efficiently than the wild-type and has been associated with higher viral load13,14. This could happen by limiting how much virus could replicate early in the skin inside the nose and nasopharynx (the upper part of the throat), saidMkel, who is also CEO of Pandemblock Oy, the company set up to develop the product. Article Soft mist inhalers are propellant-free devices that are slightly larger than conventional metered dose inhalers. The trial medication (placebo nasal spray, 0.02% azelastine nasal spray or 0.1% azelastine nasal spray (the latter being identically composed as the commercial anti-allergic product Pollival) was manufactured at URSAPHARM Arzneimittel GmbH, Saarbruecken, Germany). Even in cases where the antiviral does not prevent coronavirus infection, the treatment could slow infection. Therefore, the primary analysis for the viral loads was conducted non-parametrically. The study was funded by URSAPHARM Arzneimittel GmbH, Saarbruecken, Germany and CEBINA GmbH Vienna, Austria. Sign up for the Nature Briefing newsletter what matters in science, free to your inbox daily. Lee, C. & Corren, J. 3). Nat. Currently, the jury is out on their effectiveness and evidence is still limited, but it's possible they could act as a prophylactic for a short period of time. was responsible for the patient disposition. 62, 50937, Cologne, Germany, German Center for Infection Research (DZIF) Location Bonn-Cologne, Kerpener Str. But the spike protein may mutate to evade immune response. Nasal steroid sprays may reduce the severity of COVID-19, according to a new study. Google Scholar. The nasal spray is comprised of xylitol and GSE (Grapefruit Seed extract) which provides antibacterial properties as well as preventing viral adhesion in the nasal passage. Other evidence of viral infection showed similar differences between treated and untreated mice in the protective lining of cells called theepithelium inside the nose, nasal mucosa, and airways.. ISSN 1476-4687 (online) Symptoms were analyzed as single symptom scores, and as the total symptom score (TSS) reflecting the sum of all 20 single symptoms and presence/absence of fever (reaching a minimum value of 20 and maximum value of 103). and JavaScript. The Ct<25 group consisted of 19 patients in the 0.1% azelastine group, 21 patients in the 0.02% azelastine group and of 17 patients in the placebo group (Fig. All nasal sprays were composed of hypromellose, disodium edetate, citric acid, disodium phosphate dodecahydrate, sodium chloride and purified water. Furthermore, three independent groups predicted interaction of azelastine hydrochloride with the main protease of SARS-CoV-2: main protease (Mpro) or 3C-like cysteine protease (3CLpro)7,8,9. 00:00. Of those, 27 patients belonged to the 0.1% azelastine group, 28 patients to the 0.02% azelastine group and 26 patients to the placebo group (Fig. the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Approval of the study by the German Federal Institute for Drugs and Medical Devices (BfArM) was given on 3rd February 2021. Absolute changes of total symptom scores from baseline (day 1) until day 11 of treatment (ITT analysis set). JAMA Otolaryngol. You are using a browser version with limited support for CSS. R.M., S.M.S., S.A. and P.M. designed the study protocol. HG, MS, and FK declare no conflict of interest. These agents essentially trick the virus by changing the structure of the outside of cells, so they look like a virus has already fused to them. The patient status was assessed at V1V7 and at V9 by the investigators with a 11-category ordinal score proposed by the WHO11. Shapira, T. et al. The improvement of the symptom shortness of breath was significantly greater on days 3 (p=0.004) and 4 (p=0.011) in the 0.1% azelastine group compared to placebo (supplementary Figure S3). Zapor, M. Persistent detection and infectious potential of SARS-CoV-2 virus in clinical specimens from COVID-19 patients. 19(10), 16. Lancet Infect. 1). If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. The most promising compound, N-0385, virtually stopped infection in its tracks. D.G., C.S. Interestingly, significantly greater decrease in viral load was shown on day 4 of treatment in patients with high viral burden (Ct<25) treated with 0.1% azelastine compared to placebo, indicating that azelastine treatment may be advantageous for this patient population, particularly at an early timepoint of infection. Drug Resist. Levine-Tiefenbrun, M. et al. 27, 790792. 62, 50937, Cologne, Germany, Henning Gruell,Maike Schlotz&Florian Klein, Ursatec GmbH, Marpinger Weg 4, 66636, Tholey, Germany, ClinCompetence Cologne GmbH, Theodor-Heuss-Ring 14, 50668, Cologne, Germany, Belisa Russo,Susanne Mller-Scholtz,Cengizhan Acikel,Hacer Sahin,Nina Werkhuser,Silke Allekotte&Ralph Msges, Institute of Medical Statistics and Computational Biology (IMSB), Faculty of Medicine, University of Cologne, Kerpener Str. https://doi.org/10.1016/j.jinf.2021.05.009 (2021). Provided by the Springer Nature SharedIt content-sharing initiative. To evaluate the total load during the study, AUC was calculated using a linear equation. It was assumed that all treatment groups present identical baseline virus load at enrolment with a mean value of 5.5 log10 copies/mL3 SD13,14. Inhibition of SARS-CoV-2 by bentonite-based nasal spray. It also appears to . This is similar to the natural SARS-CoV-2 clearance time of approximately 2weeks. A newly discovered small molecule could be sprayed into people's noses to prevent COVID-19 illness prior to exposure and provide early treatment if administered soon after infection, according to a study in mice led by Cornell researchers. SRT was originally developed in 2009 by Dr. Thomas Hummel at the University of Dresden. . Pujadas, E. et al. https://doi.org/10.2147/idr.S391630 (2022). Categorical data were described by absolute frequencies and percentage of valid cases. New methods of fast-acting COVID-19 prevention are being researched to make it safer to be in large public gatherings like sporting events or concerts. When the treatment course was shortened to four days, starting one day before infection, all 10 of the mice treated with N-0385 survived. 147, 400401. The product targets a stable site on the spike protein of the virus that is not known to mutate. N.W. The physical and mental health summary scores of the SF-36 questionnaire improved during the course of the treatment without statistical differences between groups (data not shown). https://doi.org/10.1001/jama.2021.0202 (2021). https://doi.org/10.1080/14787210.2021.1908127 (2021). Researchers began to work on compounds that stifle TMPRSS2s ability to interact with the viral protein. A research study at Swansea University is examining the efficacy of Boots Dual Defence - a 5.99 nasal spray containing seaweed - in preventing people becoming ill with Covid and reducing the . To infect a cell, the virus tricks several of that cells proteins, including one called TMPRSS2, to gain entry. Lancet Respir. PM, MF, DG, CS and BS are employed at URSAPHARM Arzneimittel GmbH. Nature 605, 340348 (2022). Sci. But vaccines are fighting a changing opponent. In the meantime, to ensure continued support, we are displaying the site without styles . This observational study (HUN-VE: Hungarian Vaccine Effectiveness) estimated vaccine effectiveness against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and COVID-19-related mortality in 3.7 million . N. Engl. However, a rinsing and diluting effect of the placebo formulation would have led to an underestimation of the effect of the use of the azelastine nasal spray. The 0.02% azelastine group showed an AUC value of 22.6412.56, which was not significantly different from the placebo group (p=0.022, Fig. Viruses 12, 1384. https://doi.org/10.3390/v12121384 (2020). Liu, L. et al. At the end of the treatment, 48.2% of the patients of the 0.1% azelastine group showed no detection of the ORF 1a/b gene, whereas only 23.1% of patients of the placebo group showed negative PCR results (supplementary Table S4). Evaluation of AUC values (reflecting baseline adjusted decreases of viral load over 11days) showed that the 0.1% azelastine group exhibited a greater AUC value of 24.1413.12 (referring to greater decrease) compared to the placebo group with an AUC value of 18.894.70 (p=0.007, Fig. 4). Postdoctoral Associate- Immunology, T Cells, GVHD, Bone Marrow Transplantation, Postdoctoral Fellows in the VU Department of Biochemistry. CAS The researchers compared mice treated with TriSb92 before and after exposure to SARS-CoV-2. H.G., M.S., and F.K. Future studies will help understanding the impact of azelastine hydrochloride in treating SARS-CoV-2 infected patients. 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Amdal, C. D. et al. https://cornellsun.com/2022/04/27/cornell-research-team-to-develop-covid-19-nose-spray-treatment/, https://doi.org/10.1038/s41586-022-04661-w, Antiviral Nasal Spray Shows Promise Fighting COVID-19. Early intervention with azelastine nasal spray may reduce viral load in SARS-CoV-2 infected patients, https://doi.org/10.1038/s41598-023-32546-z. The liquid contains NO at 0.11 ppm*hour, which acts as a viricidal agent. Within the subgroup of patients with baseline Ct values below 25, a similar progression of viral load data was observed (Fig. Jean, F. (2022). Continuous data were described by statistical estimates (mean, standard deviation, median, minimum, and maximum values). Internet Explorer). Chem. In addition, patient's quality of life was evaluated by the SF-36 questionnaire, covering 36 items divided into the 8 quality of life domains physical functioning; role limitations due to physical health, role limitations due to emotional problems, energy/fatigue, emotional well-being, social functioning, pain, and general health12. It would be desirable to use a validated, COVID-19 specific questionnaire in future studies, and first attempts for its development are promising32. https://doi.org/10.6026/97320630016236 (2020). Since azelastine has been shown to inhibit viral replication by 99.9% in Vero E6 cell culture and in reconstituted human nasal tissue cultures, it was assumed that a reduction of 3-log in virus load would be seen within 3days in actively treated patients, while no effect on virus load reduction would be seen in placebo treated patients. SARS-CoV-2 RNA levels in nasopharyngeal swabs were determined by quantitative RT-PCR using the cobas SARS-CoV-2 Test on the cobas 6800 system (Roche Diagnostic, Mannheim, Germany). The first administration of the nasal spray was carried out in the presence of the investigator; products were subsequently self-administered for 11days (treatment phase). Although no significant differences between groups regarding the total symptom score was shown, it may be speculated that the 0.1% azelastine spray may have positive influences on single symptoms such as shortness of breath, which was improved significantly greater in this treatment group compared to placebo at early time points of infection.
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