Efficacy of normal saline nasal spray and gargle on SARS-CoV-2 for prevention of COVID-19 pneumonia

Background: Role of microaspiration of mucus mixed with SARS-CoV-2 (severe acute respiratory syndrome corona virus 2) causing pneumonia is lacking in searched literature. Recently some authors have emphasized on microaspiration. SARS-CoV-2 primarily replicates in nasal mucosa and sheds in nasal mucus which travels down as microaspiration and causes pneumonia. We aimed to evaluate the efficacy of normal saline nasal spray and gargle (NSNSG) to wash off SARS-CoV-2 from nasal and pharyngeal mucosa to prevent microaspiration and pneumonia. Methods: : From RT-PCR (reverse transcriptase polymerase chain reaction) report, we selected 62 patients for study group and 63 patients for control, having higher virion load i.e. cycle threshold (Ct) value 25 or less. Patients in study group were trained with NSNSG. We reviewed HRCT (high resolution computed tomogram) of lung in 56 patients of both groups for severity score (SS) in lung and was compared with initial HRCT Results: : Thirty out of 62 (48%) of study group significantly ( p =0·01) became RT-PCR negative following NSNSG compared to 16 out of 63 patients (25%) of control. Thirty one out of 34 patients (91%) of study group either improved or inhibited progression of SS in lung HRCT. In control group, 14 out of 22 patients (63%) also showed favourable findings. Nevertheless, study group significantly improved ( p =0·028) in SS. Conclusions: : NSNSG is significantly efficacious to wash off SARS-CoV-2 from nasal cavity and pharynx, and to break supply chain of SARS-CoV-2 from source to prevent microaspiration in lung alveoli and pneumonia. From that phenomenon we infer that SARS-CoV-2 as a ‘surface virus’ and it seems that vaccine resistant SARS-CoV-2 and different strains of SARS-CoV-2 would be washed off with NSNSG.