Effectiveness of hydrogen peroxide as auxiliary treatment for hospitalized COVID-19 patients in Brazil: preliminary results of a randomized double-blind clinical trial

Epidemiol Health. 2021:43:e2021032. doi: 10.4178/epih.e2021032. Epub 2021 May 1.

Abstract

Objectives: To evaluate the effectiveness of hydrogen peroxide (H2O2) in the form of mouthwash and nasal spray as an auxiliary treatment for coronavirus disease 2019 (COVID-19).

Methods: Forty hospitalized patients who tested positive for severe acute respiratory syndrome coronavirus 2 using a reverse-transcription polymerase chain reaction test were evaluated. They were randomly divided into an experimental group (n= 20; gargling with 1.0% H2O2 and nasal wash with 0.5% H2O2) or a control group (n= 20). The solutions were used for 7 days and the patients were monitored every 2 days, for a total of 8 days. At check-ups, patients were asked about their symptoms and possible adverse effects of the solutions. The presence and severity (mild, moderate, or severe) of symptoms were recorded. Data were compared using the Student test and the Fisher exact test (α= 0.05).

Results: There was no significant difference between the 2 groups in the length of hospital stay (p= 0.65). The most frequent symptom on day 0 was coughing (72.0% in the experimental group and 76.5% in the control group), which abated over time. There was no significant difference between the groups in the evaluated symptoms. Most (75.0%) of the patients in the experimental group presented a reduction in dyspnea between days 0 and 2. Few patients reported adverse effects from the use of the solutions.

Conclusions: H2O2 as a mouthwash and nasal spray is safe to use. There is insufficient evidence to demonstrate that H2O2 is effective as an auxiliary treatment for hospitalized COVID-19 patients.

Keywords: COVID-19; Hydrogen peroxide; Mouthwashes; Nasal sprays; SARS-CoV-2.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Anti-Infective Agents, Local / administration & dosage*
  • Brazil
  • COVID-19 / virology
  • COVID-19 Drug Treatment*
  • Double-Blind Method
  • Female
  • Hospitalization
  • Humans
  • Hydrogen Peroxide / administration & dosage*
  • Male
  • Middle Aged
  • Mouthwashes / administration & dosage
  • Nasal Sprays
  • SARS-CoV-2*
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Anti-Infective Agents, Local
  • Mouthwashes
  • Nasal Sprays
  • Hydrogen Peroxide