Starting twice daily flushing of the nasal cavity with a mild saline solution soon after testing positive for Covid-19 may reduce hospitalisation due to the viral disease

Nasal saline flushing is a common practice in every household since ages. Generation have recommended their younger ones to perform a saline nasal flush at least once a day to keep the dirt away from their nasal passage. However, a recent study published in Ear, Nose & Throat Journal has also shown that if one undergoes nasal saline flushing at least twice a day, it would also reduce the severity of Covid-19. That's right! Your granny's recommendation stands true even during a pandemic. 

"By giving extra hydration to your sinuses, it makes them function better," said Amy Baxter, from Augusta University, US.

"If you have a contaminant, the more you flush it out, the better you are able to get rid of dirt, viruses and anything else," said Baxter, corresponding author of the study.

What is nasal saline flushing?

Starting twice daily flushing of the nasal cavity with a mild saline solution soon after testing positive for Covid-19 may reduce hospitalisation due to the viral disease, a study claims.

The technique involves mixing a half teaspoon each of salt and baking soda in a cup of boiled water and then putting it into a sinus rinse bottle, making it a safe, effective and inexpensive way that can have a vital public health impact.

Participants 55 and older were enrolled within 24 hours of a positiveCOVID-19 test between 24 September and 21 December in 2020. Among 826 screened, 79 participants were enrolled and randomly assigned to add 2.5 mL povidone-iodine 10% or 2.5 mL sodium bicarbonate to 240 mL of isotonic nasal irrigation twice daily for 14 days. 

Less than 1.3% of the 79 subjects aged 55 and older who enrolled experienced hospitalisation, and no one died, the researchers said.

Among the participants, who were treated and followed for 28 days, one participant was admitted to the hospital and another went to the emergency room but was not admitted, they said.

How does nasal saline flushing reduce Covid-19 severity?

The SARS-CoV-2 virus is known to attach to the ACE2 receptor, which is pervasive throughout the body and in abundance in locations like the nasal cavity, mouth and lungs.

Drugs that interfere with the virus' ability to attach to ACE2 have been pursued, and Baxter said the nasal irrigation with saline helps decrease the usual robust attachment.

Saline appears to inhibit the virus' ability to essentially make two cuts in itself, called furin cleavage, so it can better fit into an ACE2 receptor once it spots one.

Participants self-administered nasal irrigation using either antiseptic povidone-iodine, or baking soda, mixed with water that had the same salt concentration normally found in the body.

While the researchers found the additives really added no value, previous research had indicated they might help, for example, make it more difficult for the virus to attach to the ACE2 receptor.

Twenty-three of the 29 participants who consistently irrigated twice daily had zero or one symptom at the end of two weeks compared to 14 of the 33 who were less diligent, the researchers said.

Sixty-two of the participants completed a daily survey, reporting 1.8 irrigations daily; 11 reported irrigation-related complaints and four discontinued use.

Other studies have shown the nasal irrigation, also called lavage, can also be effective in reducing duration and severity of infection by a family of viruses that include the coronaviruses, as well as the influenza viruses, the researchers added.

SARS-CoV-2+ participants initiating nasal irrigation were over 8 times less likely to be hospitalized than the national rate.

Those who completed nasal irrigation twice daily reported quicker resolution of symptoms regardless of which of two common antiseptics they were adding to the saline water, they said. 

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