Role of Naso-oropharyngeal Antiseptic Decolonization to Reduce COVID-19 Viral Shedding and Disease Transmission: SHIELD Study

At a Glance

Healthcare workers caring for COVID-19 patients are at high risk of contracting and spreading the virus. Early in the pandemic, there was an urgent need for effective, safe, and easily implementable strategies to reduce the spread of COVID-19. Researchers aimed to evaluate the feasibility of and effects of decontamination interventions including nasal solution and an oral mouthwash on virologic shedding, transmission, and infection outcomes in healthcare workers involved in COVID-19 patient care. Researchers were successful in completing this project. Participants reported high acceptability of the interventions and 73 percent of respondents were willing to use the interventions moving forward.

Project Goals

Researchers hypothesized that a povidone-iodine nasal solution and an oral chlorhexidine gluconate mouthwash would be feasible and effective viral decontaminants for healthcare workers caring for COVID-19 patients. Both are antiseptic agents that are commonly used in healthcare settings to kill microorganisms that can cause infections. These compounds have been proven safe in cleaning the skin, nose, and mouth.

Researchers addressed this hypothesis through two specific aims. First, they planned to evaluate the feasibility and fidelity of a nasal and oral decontamination procedure to reduce COVID-19 infections in healthcare workers caring for patients with COVID-19. Additionally, they sought to evaluate the effects of these decontamination procedures on virologic shedding (when a person is contagious and releases copies of a virus from their bodies), transmission, and infection outcomes among healthcare workers involved in COVID-19 patient care.

Results

The feasibility and fidelity of the decontamination procedures were assessed using a pre- and post-intervention survey. The surveys asked participants to answer the following question, “I feel the overall acceptability of the study intervention will be/is:” on a 5-point scale that ranged from 1-not at all to 5-extremely. The actual acceptability of the intervention as reported on the post-intervention survey, 3.82, was generally lower than the perceived acceptability on the pre-intervention survey, 4.19. However, the overall acceptability was still high. Additionally, 73 percent of participants reported willingness to use the intervention moving forward. The participants who were unwilling to use the intervention moving forward expressed that the decontamination intervention was burdensome as it required multiple applications per day, and that they experienced some side effects from the nasal solution and/or oral mouthwash.

In addition to these outcomes, researchers forged a new partnership with the Virology Services team. This new collaboration will serve the research team well in developing new strategies and grant applications focused on evaluating interventions to reduce and/or inhibit SARS-CoV-2 transmission.