Journal of Family Medicine and Primary Care (Jan 2022)

Changes in reverse transcription polymerase chain reaction cycle threshold values of SARS-CoV-2 with topical povidone iodine use: A single-arm open-label interventional study

  • Sumita Shankar,
  • Limalemla Jamir,
  • Rakesh Kakkar,
  • Korukonda Babji,
  • V Mangayarkarasi,
  • Mukesh Tripathi,
  • Heena Tak

DOI
https://doi.org/10.4103/jfmpc.jfmpc_993_21
Journal volume & issue
Vol. 11, no. 2
pp. 480 – 486

Abstract

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Context: Repurposed povidone iodine (PVP-I) has been suggested as an effective adjuvant against coronavirus disease-2019 (COVID-19). Aim: The aim of this study was to assess the changes in RT-PCR cycle threshold (Ct) values of severe acute respiratory Syndrome Coronavirus-2 (SARS-CoV-2) genes with PVP-I intranasal and oral application. Settings and Design: A longitudinal (repeated measures) single-arm open-label interventional study was conducted for 200 samples of ten COVID-19 patients in South India. Methods and Material: Demographic and clinical information were collected. Intranasal application and oral gargle with 1% PVP-I solution was done four times a day for seven days. Nasopharyngeal and oropharyngeal samples were taken for RT-PCR test at hour-0, hour-2, hour-4 on Day-0, Day-3, Day-6, and hour-0 on Day-9. Statistical Analysis Used: STATA analysis software version 14.2 was used. McNemar Test was applied for paired samples. Skilling Mack Test was used to assess the association between PVP-I use (intra-day and inter-day) and E gene/N gene Ct values. Pearson correlation coefficients and Bland-Altman plots were used for further analyses. Results: Mean (SD) age of the patients was 41.5 (±8.82) years. A total of 100 pairs of nasopharyngeal and oropharyngeal samples were analysed. No significant difference was observed in the Ct values of asymptomatic and symptomatic patients. E gene Ct values (nasopharyngeal) at Hour-0 increased from Day-0 to Day-9 (P = 0.005). Ct value was higher at Hour-2 for most of the samples. Conclusions: RT-PCR results (qualitative) differed at various testing points in the same patients. Lower Ct values were found in the nasopharyngeal samples. Successive increase in E gene Ct values indicates reduced viral load with natural course of COVID-19. PVP-I may have an optimal impact within 2 h of usage. Clinical trial registration number: CTRI/2020/05/024962.

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