key: cord-1038694-w939rrhm
authors: Ortega, Karem López; de Oliveira Rech, Bruna; Ferreira Costa, Andre Luiz; Pérez Sayáns, Mario; Braz‐Silva, Paulo Henrique
title: Is 0.5% Hydrogen Peroxide Effective against SARS‐CoV‐2?
date: 2020-06-21
journal: Oral Dis
DOI: 10.1111/odi.13503
sha: 6f3ecfe48b837f2fb6b8064ff1d25758f3e47791
doc_id: 1038694
cord_uid: w939rrhm

SARS‐CoV‐2 is mostly transmitted through respiratory droplets and contact routes, but the WHO also states that “airborne transmission may be possible in specific circumstances and settings in which procedures or support treatments that generate aerosols are performed” (WHO, 2020).

This article is protected by copyright. All rights reserved against other coronaviruses have been evaluated (Kampf, Todt, Pfaender, & Steinmann, 2020) . A recent review reports that application of 0.5% hydrogen peroxide for 1 minute can be used as a surface disinfectant due to its virucidal activity against human coronavirus (Kampf et al., 2020) . The applicability of hydrogen peroxide as disinfectant has been widely explored in the literature, but the concentrations used are much higher than that reported (Kampf et al., 2020) . High concentrations of hydrogen peroxide can counter the decrease in efficacy when the compound is degraded in water and oxygen after reacting with catalase (Rutala, Gergen, & Weber, 2008) . In addition to the concentration of the hydrogen peroxide, another crucial factor is the need for high temperatures (Rutala et al., 2008) .

In order to assess the literature on the virucidal effect of hydrogen peroxide for surface disinfection, we have performed an electronic search on PubMed, registered in the International Prospective Register of Systematic Reviews (PROSPERO) according to protocol number CRD42020190033, by using the following terms: "hydrogen peroxide", "virucidal", "disinfection", "cleanse", "decontaminate", "sanitize", "antiseptic", "coronavirus", "covid-19", "sarscov 2", "virus", "HPV" and "MERS". A total of 28 articles were found, and we have excluded studies not evaluating surface cleaning or those mixing other compounds with hydrogen peroxide. Reviews, letters to the editor, personal opinions, textbook chapters, case reports and congress abstracts were also excluded.

Therefore, 11 studies remained and their data are summarized in Table 1 . We found only three coronaviruses inactivated by hydrogen peroxide in these studies, two in animals (PRCV and TGEV) and one in humans (SARS).

Because we have found no study using hydrogen peroxide at 0.5% as a viable substance for surface disinfection, we conducted a further reading based on the reference used by Kampf. A study published by Omidbakhsh & Sattar(Omidbakhsh & Sattar, 2006 ) assessed a product based on accelerated hydrogen peroxide (AHP) (Virox® Technologies Inc, Oakville, Canada) whose manufacture states the following: "a patented disinfectant synergistic blend of commonly used, safe ingredients that when combined with low levels of hydrogen peroxide dramatically increases its germicidal potency and cleaning performance" (Diversey, 2020; Ramirez & Rochon, 2002) .

This article is protected by copyright. All rights reserved Therefore, the study cited by Kampf does not address the use of 0.5% hydrogen peroxide and there is no study in the literature demonstrating its efficacy as a virucidal agent for surface disinfection either. In fact, we have actually found on PubMed only one study assessing the efficacy of hydrogen peroxide on human coronavirus (SARS), reporting that the virus is inactivated by the substance in the form of vapour at a 35% concentration (Goyal, Chander, Yezli, & Otter, 2014) .

Reliable information on disinfection of surfaces based on scientific evidence is fundamental so that healthcare services can provide safe settings for professionals and patients, thus contributing to the control of infections.

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The authors would like to thank José Tadeu Sales for the language correction of the manuscript.