key: cord-0701929-f5j2vlvg authors: Vilhena, Fabiano Vieira; Brito Reia, Verônica Caroline; da Fonseca Orcina, Bernardo; Santos, Caíque Andrade; Zangrando, Mariana; Cardoso de Oliveira, Rodrigo; da Silva Santos, Paulo Sérgio title: The use of antiviral Phthalocyanine mouthwash as a preventive measure against COVID-19 date: 2021-07-09 journal: GMS Hyg Infect Control DOI: 10.3205/dgkh000395 sha: 953885bc892d868de68630048306699d7c4b9d66 doc_id: 701929 cord_uid: f5j2vlvg nan Vaccines and other drugs have been developed and delivered to fight SARS-CoV-2. Successful measures to prevent infection with the virus, such as wearing masks, attention to hygiene and social distancing in conjunction with antiviral mouthwashes, have been recommended to the population for daily use during the COVID-19 pandemic [1] , [2] . Scientific evidence has shown the presence of viruses in oral structures and indications for antiviral oral antiseptics have been investigated. Thus, in vitro studies with mouthwashes against coronavirus published during the pandemic seemed promising [3] . However, until September 2020 there was no clinical or laboratorial evidence for their indication, since only few studies had been published [4] . In March 2021 (Ather et al. 2021 [5] ), based on the available evidence. It was demonstrated that the use of antiviral oral antiseptics (mouthrinses) had the potential to reduce the in vitro viral load of SARS-CoV-2, but the in vivo effectiveness was still inconclusive [5] . Only in April 2021 was it suggested that there was sufficient in vitro and in vivo evidence of the effectiveness of some oral antiseptics in inactivating SARS-CoV-2 and other coronaviruses [6] (Figure 1 ). Our research group reinforces the claims for the potential of antiviral mouthwashes to combat COVID-19. Recently, an in vitro evaluation of the virucidal activity of a mouthwash containing antiviral phthalocyanine derivative (APD), a substance that can promote reactive oxygen species generation or redox processes [7] , was conducted according to the TCID50 methodology (Median Tissue Culture Infectious Dose). The periods of 30 seconds, 1 minute, This is another relevant result of the positive action of APD, since a reduction in the viral load of SARS-CoV-2 above 90% has already been demonstrated in previous in vitro studies [8] , [9] , as well as the rapid clinical improvement of COVID-19 symptoms [10] . In a randomized study conducted in a hospital environment, COVID-19 patients with mild and moderate cases underwent an adjuvant APD mouthwash protocol. The APD mouthwash group, with a maximum of 7 days of symptoms associated with conventional treatment for COVID-19, was discharged sooner (4 days median). This group also presented lower disease severity (without intensive care unit [ICU] or deaths) when compared to the non-APD mouthwash group (7 days median, 28.6% ICU, 14.3% mortality rate) [8] . In short, the prospect of a low-cost, hygienic personalcare method, suggestive of good option such as the use of antiviral oral antiseptic, may be an important strategy for reducing the impact of COVID-19. Competing interests Virucidal gargling and virucidal nasal spray. GMS Hyg Infect Control A Recommendation of PHTALOX® Mouthwash for Preventing Infection and Progression of COVID-19 Virucidal Efficacy of Different Oral Rinses Against Severe Acute Respiratory Syndrome Coronavirus 2 Antiviral Activity of Reagents in Mouth Rinses against SARS-CoV-2 Efficacy of Mouth Rinses Against SARS-CoV-2: A Scoping Review Oral antiseptics against coronavirus: in-vitro and clinical evidence PHTALOX® Antimicrobial Action and Cytotoxicity: in vitro Study Beneficial effects of a mouthwash containing an antiviral phthalocyanine derivative on the length of hospital stay for COVID-19 Virucidal Activity of the Antiseptic Mouthwash and Dental Gel Containing Anionic Phthalocyanine Derivative: In vitro Study A Phthalocyanine Derivate Mouthwash to Gargling/Rinsing as an Option to Reduce Clinical Symptoms of COVID-19: Case Series The use of antiviral Phthalocyanine mouthwash as a preventive measure against COVID-19 CROP Biotechnology for the experimental design and execution.