{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T01:16:58Z","timestamp":1773105418676,"version":"3.50.1"},"reference-count":21,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T00:00:00Z","timestamp":1636416000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>To determine the effect of povidone\u2010iodine (PVP\u2010I) nasal sprays on nasopharyngeal (NP) viral load as assessed by cycle threshold (Ct) on quantitative polymerase chain reaction (qPCR) of SARS\u2010CoV\u20102 in outpatients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Three arm, triple blinded, randomized, placebo\u2010controlled clinical trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Participants were randomized within 5\u2009days of testing positive for COVID\u201019 to receive nasal sprays containing placebo (0.9% saline), 0.5% PVP\u2010I, or 2.0% PVP\u2010I. NP swabs for qPCR analysis were taken at baseline, 1\u2010hour post\u2010PVP\u2010I spray (two sprays\/nostril), and 3\u2009days post\u2010PVP\u2010I spray (20 sprays\/nostril). Symptom and adverse event questionnaires were completed at baseline, day 3, and day 5. University of Pennsylvania Smell Identification Tests (UPSIT) were completed at baseline and day 30.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mean Ct values increased over time in all groups, indicating declining viral loads, with no statistically significant difference noted in the rate of change between placebo and PVP\u2010I groups. The 2.0% PVP\u2010I group showed statistically significant improvement in all symptom categories; however, it also reported a high rate of nasal burning. Olfaction via UPSIT showed improvement by at least one category in all groups. There were no hospitalizations or mortalities within 30\u2009days of study enrollment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Saline and low concentration PVP\u2010I nasal sprays are well tolerated. Similar reductions in SARS\u2010CoV\u20102 NP viral load were seen over time in all groups. All treatment groups showed improvement in olfaction over 30\u2009days. These data suggest that dilute versions of PVP\u2010I nasal spray are safe for topical use in the nasal cavity, but that PVP\u2010I does not demonstrate virucidal activity in COVID\u201019 positive outpatients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>2 <jats:italic>Laryngoscope<\/jats:italic>, 132:2089\u20132095, 2022<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.29935","type":"journal-article","created":{"date-parts":[[2021,11,1]],"date-time":"2021-11-01T14:14:45Z","timestamp":1635776085000},"page":"2089-2095","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["The Effect of <scp>Povidone\u2010Iodine<\/scp> Nasal Spray on Nasopharyngeal SARS\u2010CoV\u20102 Viral Load: A Randomized Control Trial"],"prefix":"10.1002","volume":"132","author":[{"given":"David","family":"Zarabanda","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Stanford University School of Medicine  Stanford California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1787-935X","authenticated-orcid":false,"given":"Neelaysh","family":"Vukkadala","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Stanford University School of Medicine  Stanford California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katie M.","family":"Phillips","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of Cincinnati School of Medicine  Cincinnati Ohio U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4150-1023","authenticated-orcid":false,"given":"Z. Jason","family":"Qian","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Stanford University School of Medicine  Stanford California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenji O.","family":"Mfuh","sequence":"additional","affiliation":[{"name":"Clinical Virology Laboratory Stanford Health Care  Stanford California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew J.","family":"Hatter","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Stanford University School of Medicine  Stanford California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivan T.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Stanford University School of Medicine  Stanford California U.S.A."},{"name":"Division of Allergy and Immunology, Department of Pediatrics Stanford University School of Medicine  Stanford California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vidya K.","family":"Rao","sequence":"additional","affiliation":[{"name":"Divisions of Cardiothoracic Anesthesiology and Critical Medicine, Department of Anesthesiology, Perioperative and Pain Medicine Stanford University School of Medicine  Stanford California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter H.","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Stanford University School of Medicine  Stanford California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Domb","sequence":"additional","affiliation":[{"name":"Shasta\u2010ENT Medical Group  Redding California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2072-982X","authenticated-orcid":false,"given":"Zara M.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Stanford University School of Medicine  Stanford California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin A.","family":"Pinsky","sequence":"additional","affiliation":[{"name":"Clinical Virology Laboratory Stanford Health Care  Stanford California U.S.A."},{"name":"Department of Pathology Stanford University School of Medicine  Stanford California U.S.A."},{"name":"Division of Infectious Diseases and Geographic Medicine, Department of Medicine Stanford University School of Medicine  Stanford California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4454-0861","authenticated-orcid":false,"given":"Jayakar V.","family":"Nayak","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Stanford University School of Medicine  Stanford California U.S.A."},{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Veterans Affairs Palo Alto Health Care System  Palo Alto California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,11,9]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2034577"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2035389"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-020-0868-6"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-020-19145-6"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-020-19057-5"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.202008-931RL"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.04624-14"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1086\/501620"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40121-020-00316-3"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2020.3053"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1159\/000097758"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.2139\/ssrn.3563092"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22579"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2020.5490"},{"key":"e_1_2_6_16_1","unstructured":"UrbaniakG PlousS.Research Randomizer.2013. 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