New study: gargling with salt water may help prevent Covid hospitalization

ANAHEIM, Calif. (Nov. 9, 2023) – As Covid and its health effects move into a fourth year, those who become infected may be searching for remedies to improve their respiratory symptoms and keep them out of the hospital. A new study being presented at this year’s American College of Allergy, Asthma and Immunology (ACAAI) Annual Scientific Meeting in Anaheim, Calif. determined that both a low- and high-dose saline regimen appeared to be associated with lower hospitalization rates compared to controls in SARS-CoV-2 infections.

“Between 2020 and 2022, individuals aged 18-65 years with positive PCR test for SARS-CoV-2 infection were randomly selected to undergo low- or high-dose saline regimens for 14 days,” says Sebastian Espinoza, lead author of the study. “The low- and high-saline solutions consisted of 2.13 grams and 6 grams of salt dissolved in 8 ounces of warm water, respectively. Gargling and nasal rinsing was done four times a day for 14 days. Primary outcomes included frequency and duration of symptoms associated with SARS-CoV-2 infection; secondary outcomes included hospital or ICU admission, mechanical ventilatory support, or death. Exclusion criteria were chronic hypertension or participation in another interventional study. Those on the low- and high-dose saline solutions, as well as those in the reference population, had similar rates of vaccination.”

58 individuals were allocated to either the low (27) or high (28) saline regimens; 3 were lost to follow-up. There were no significant differences in the primary or secondary outcomes of the study between these two groups. During the study period, 9,398 individuals with positive SARS-CoV-2 infection were evaluated and were the reference population. The hospitalization rates in the low- (18.5%) and high- (21.4%) saline regimens were significantly lower than in the reference population (58.8%.) No significant differences were noted in other outcomes among these groups.

“Our goal was to examine saline nasal irrigation and gargling for possible association to improved respiratory symptoms associated with coronavirus infection,” says Jimmy Espinoza, MD, co-author of the study. “We found that both saline regimens appear to be associated with lower hospitalization rates compared to controls in SARS-CoV-2 infections. We hope more studies can be done to further investigate the association.”

Abstract Title: Double blind randomized controlled trial of saline solution gargling and nasal rinsing in SARS-CoV-2 infection  

Presenter: Sebastian Espinoza

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Double blind randomized controlled trial of saline solution gargling and nasal rinsing in SARS-CoV-2 infection  

S. Espinoza^*1, L. Trauffler², A. Shamshirsaz², A. Shamshirsaz³, A. Espinoza², J. Espinoza², A. O’Brien², 1. Sugar Land, TX; 2. Houston, TX; 3. Boston, MA.

Introduction: Saline nasal irrigation and gargling improve respiratory symptoms associated with coronavirus infection. This study determines the role of two saline regimens on symptoms associated with SARS-CoV-2.
Methods: Between 2020 and 2022, individuals aged 18-65 years with positive PCR test for SARS-CoV-2 infection were randomly allocated to low- or high-saline regimens for 14 days. Low- and high-saline solutions consisted of 2.13 grams and 6 grams of salt dissolved in 8 ounces of warm water, respectively. Gargling and nasal rinsing was done four times a day for 14 days. Primary outcomes included frequency and duration of symptoms associated with SARS-CoV-2 infection; secondary outcomes included hospital or ICU admission, mechanical ventilatory support, or death. Exclusion criteria were: chronic hypertension or participation in other interventional study.
Results: 58 individuals were allocated to the low-(n=27) or high-(n=28) saline regimens; 3 were lost to follow-up. There were no significant differences in the primary or secondary outcomes of the study between these two arms (Table 1). During the study period, 9,398 individuals with positive SARS-CoV-2 infection were evaluated (reference population). The hospitalization rates in the low-(18.5%) and high-(21.4%) saline regimens were significantly lower than in the reference population (58.8%; p<0.001). No significant differences were noted in other outcomes among these groups (Table 1).
Conclusion: 1) Low- and high- saline regimens for gargling and nasal rinsing are associated with similar frequency and duration of symptoms related with SARS-CoV-2 infection. 2) Both saline regimens appear to be associated with lower hospitalization rates compared to controls in SARS-CoV-2 infections.

Table 1: Demographic and clinical characteristics of the study population

Data expressed as percentage (proportions) or median (range). p1: comparison between low and high-salt regimen. P2: comparison between low-salt regimen and reference population; p3: comparison between high-salt regimen and reference population. *Symptoms: fever or chills, cough, sore throat, shortness of breath, difficulty breathing, headache, new loss of taste or smell, muscle or body aches, fatigue, nausea, vomiting, diarrhea.

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