{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T02:53:10Z","timestamp":1784775190892,"version":"3.55.0"},"reference-count":158,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2021,10,3]],"date-time":"2021-10-03T00:00:00Z","timestamp":1633219200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceutics"],"abstract":"<jats:p>Despite the progress made in the fight against the COVID-19 pandemic, it still poses dramatic challenges for scientists around the world. Various approaches are applied, including repurposed medications and alternative routes for administration. Several vaccines have been approved, and many more are under clinical and preclinical investigation. This review aims to systemize the available information and to outline the key therapeutic strategies for COVID-19, based on the nasal route of administration.<\/jats:p>","DOI":"10.3390\/pharmaceutics13101612","type":"journal-article","created":{"date-parts":[[2021,10,8]],"date-time":"2021-10-08T21:26:20Z","timestamp":1633728380000},"page":"1612","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Can the Nasal Cavity Help Tackle COVID-19?"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5737-536X","authenticated-orcid":false,"given":"Bissera","family":"Pilicheva","sequence":"first","affiliation":[{"name":"Department of Pharmaceutical Sciences, Faculty of Pharmacy, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria"},{"name":"Research Institute at Medical University of Plovdiv, 4002 Plovdiv, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Radka","family":"Boyuklieva","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Sciences, Faculty of Pharmacy, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,10,3]]},"reference":[{"key":"ref_1","unstructured":"(2021, August 15). COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU). Available online: https:\/\/publichealthupdate.com\/jhu\/."},{"key":"ref_2","first-page":"6976","article-title":"The proportion of SARS-CoV-2 infections that are asymptomatic: A systematic review","volume":"174","author":"Oran","year":"2021","journal-title":"Ann. Intern. Med."},{"key":"ref_3","unstructured":"(2021, August 15). COVID-19 and Your Health. Centers for Disease Control and Prevention, Available online: https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/long-term-effects.html."},{"key":"ref_4","first-page":"1","article-title":"Molecular mechanism of interaction between SARS-CoV-2 and host cells and interventional therapy","volume":"6","author":"Zhang","year":"2021","journal-title":"Signal Transduct. Target. Ther."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1444","DOI":"10.1126\/science.abb2762","article-title":"Structural basis for the recognition of SARS-CoV-2 by full-length human ACE2","volume":"367","author":"Yan","year":"2020","journal-title":"Science"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Wan, Y., Shang, J., Graham, R., Baric, R.S., and Li, F. (2020). Receptor Recognition by the Novel Coronavirus from Wuhan: An Analysis Based on Decade-Long Structural Studies of SARS Coronavirus. J. Virol., 94.","DOI":"10.1128\/JVI.00127-20"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Kumari, P., Rothan, H.A., Natekar, J.P., Stone, S., Pathak, H., Strate, P., Arora, K., Brinton, M.A., and Kumar, M. (2021). Neuroinvasion and encephalitis following intranasal inoculation of SARS-CoV-2 in K18-hACE2 Mice. Viruses, 13.","DOI":"10.1101\/2020.12.14.422714"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Murgolo, N., Therien, A.G., Howell, B., Klein, D., Koeplinger, K., Lieberman, L.A., Adam, G.C., Flynn, J., McKenna, P., and Swaminathan, G. (2021). SARS-CoV-2 tropism, entry, replication, and propagation: Considerations for drug discovery and development. PLOS Pathog., 17.","DOI":"10.1371\/journal.ppat.1009225"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1038\/s41591-020-0868-6","article-title":"SARS-CoV-2 entry factors are highly expressed in nasal epithelial cells together with innate immune genes","volume":"26","author":"Sungnak","year":"2020","journal-title":"Nat. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1007\/s11684-020-0754-0","article-title":"Single-cell RNA-seq data analysis on the receptor ACE2 expression reveals the potential risk of different human organs vulnerable to 2019-nCoV infection","volume":"14","author":"Zou","year":"2020","journal-title":"Front. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.bbrc.2020.03.044","article-title":"Single cell RNA sequencing of 13 human tissues identify cell types and receptors of human coronaviruses","volume":"526","author":"Qi","year":"2020","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1002\/path.1570","article-title":"Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis","volume":"203","author":"Hamming","year":"2004","journal-title":"J. Pathol."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Chen, M., Shen, W., Rowan, N.R., Kulaga, H., Hillel, A., Ramanathan, M., and Lane, A.P. (2020). Elevated ACE2 expression in the olfactory neuroepithelium: Implications for anosmia and upper respiratory SARS-CoV-2 entry and replication. Eur. Respir. J., 2001948.","DOI":"10.1101\/2020.05.08.084996"},{"key":"ref_14","unstructured":"Johns Hopkins Medicine (2020, August 20). Study Adds to Evidence that Cells in the Nose Are Key Entry Point for SARS CoV-2. ScienceDaily. Available online: www.sciencedaily.com\/releases\/2020\/08\/200820102428.htm."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2427","DOI":"10.1001\/jama.2020.8707","article-title":"Nasal Gene Expression of Angiotensin-Converting Enzyme 2 in Children and Adults","volume":"323","author":"Bunyavanich","year":"2020","journal-title":"JAMA"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1796","DOI":"10.4049\/jimmunol.168.4.1796","article-title":"Nasal-associated lymphoid tissue is a mucosal induc-tive site for virus-specific humoral and cellular immune responses","volume":"168","author":"Zuercher","year":"2002","journal-title":"J. Immunol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1111\/j.1365-2249.2003.02311.x","article-title":"Nasal-associated lymphoid tissue (NALT): Frequency and localization in young children","volume":"134","author":"Debertin","year":"2003","journal-title":"Clin. Exp. Immunol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/S0022-1759(96)00243-8","article-title":"Isolation and characterization of mouse nasal-associated lymphoid tissue","volume":"202","author":"Asanuma","year":"1997","journal-title":"J. Immunol. Methods"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1038\/nri1439","article-title":"NALT- versus PEYER\u2019S-patch-mediated mucosal immunity","volume":"4","author":"Kiyono","year":"2004","journal-title":"Nat. Rev. Immunol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1111\/j.1574-695X.2007.00359.x","article-title":"M-cells: Origin, morphology and role in mucosal immunity and microbial pathogenesis","volume":"52","author":"Corr","year":"2008","journal-title":"FEMS Immunol. Med. Microbiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1007\/s004289900177","article-title":"Evidence of M cells as portals of entry for antigens in the nasopharyngeal lymphoid tissue of humans","volume":"436","author":"Fujimura","year":"2000","journal-title":"Virchows. Archiv."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1517\/14712598.3.3.519","article-title":"Nasal drug delivery","volume":"3","author":"Suman","year":"2003","journal-title":"Expert Opin. Biol. Ther."},{"key":"ref_23","first-page":"729","article-title":"Advantages of Intranasal Vaccination and Considerations on Device Selection","volume":"71","author":"Birkhoff","year":"2009","journal-title":"Indian J. Pharm. Sci."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1521","DOI":"10.1016\/j.addr.2007.08.019","article-title":"Current challenges in non-invasive insulin delivery systems: A com-parative review","volume":"59","author":"Khafagy","year":"2007","journal-title":"Adv. Drug Deliv. Rev."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"3754","DOI":"10.3390\/molecules14093754","article-title":"Nasal Delivery of High Molecular Weight Drugs","volume":"14","author":"Cevher","year":"2009","journal-title":"Molecules"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/S0169-409X(97)00059-8","article-title":"Nasal mucociliary clearance as a factor in nasal drug delivery","volume":"29","author":"Marttin","year":"1998","journal-title":"Adv. Drug Deliv. Rev."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/S0169-409X(01)00172-7","article-title":"The nose and paranasal sinuses physiology and anatomy","volume":"51","author":"Jones","year":"2001","journal-title":"Adv. Drug Deliv. Rev."},{"key":"ref_28","first-page":"59","article-title":"Nasal route: A novelistic approach for targeted drug delivery to CNS","volume":"4","author":"Rakhi","year":"2013","journal-title":"Int. Re.s J. Pharm."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"771","DOI":"10.3109\/1061186X.2010.523790","article-title":"Nasal vaccine innovation","volume":"18","year":"2010","journal-title":"J. Drug Target."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Ramvikas, M., Arumugam, M., Chakrabarti, S., and Jaganathan, K. (2016). Nasal Vaccine Delivery. Micro Nanotechnol. Vaccine Dev., 279\u2013301.","DOI":"10.1016\/B978-0-323-39981-4.00015-4"},{"key":"ref_31","first-page":"94","article-title":"Nasal drug delivery: An approach of drug delivery through nasal route","volume":"2","author":"Dey","year":"2011","journal-title":"Der Pharmacia Sinica"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"455","DOI":"10.3109\/10611869609015965","article-title":"Nasal Delivery of Vaccines","volume":"3","author":"Almeida","year":"1996","journal-title":"J. Drug Target."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1007\/s11095-009-0011-3","article-title":"Mucosal vaccines: Recent progress in understanding the natu-ral barriers","volume":"27","author":"Borges","year":"2010","journal-title":"Pharm. Res."},{"key":"ref_34","first-page":"1","article-title":"Development of nasal drug delivery: A review","volume":"2","author":"Aurora","year":"2002","journal-title":"Drug Dev. Deliv."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1615\/CritRevTherDrugCarrierSyst.v26.i1.10","article-title":"Dry powder nasal vaccines as an alternative to needle-based delivery","volume":"26","author":"Hickey","year":"2009","journal-title":"Crit. Rev. Ther. Drug Carr. Syst."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1038\/nri2868","article-title":"Vaccine delivery: A matter of size, geometry, kinetics and molecular patterns","volume":"10","author":"Bachmann","year":"2010","journal-title":"Nat. Rev. Immunol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1016\/j.addr.2007.05.017","article-title":"Nanotechnology in vaccine delivery","volume":"60","author":"Peek","year":"2008","journal-title":"Adv. Drug Deliv. Rev."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"6282","DOI":"10.1016\/j.vaccine.2010.06.121","article-title":"Nasal vaccination with N-trimethyl chitosan and PLGA based nanoparticles: Nanoparticle characteristics determine quality and strength of the antibody response in mice against the encapsulated antigen","volume":"28","author":"Bal","year":"2010","journal-title":"Vaccine"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1517\/17425247.2010.488687","article-title":"Liposomes as delivery systems for nasal vaccination: Strategies and outcomes","volume":"7","author":"Heurtault","year":"2010","journal-title":"Expert Opin. Drug Deliv."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1002\/jps.21493","article-title":"Pharmaceutical Aspects of Intranasal Delivery of Vaccines Using Particulate Systems","volume":"98","author":"Sharma","year":"2009","journal-title":"J. Pharm. Sci."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1016\/j.addr.2007.04.007","article-title":"Solid lipid nanoparticles as a drug delivery system for peptides and proteins","volume":"59","author":"Almeida","year":"2007","journal-title":"Adv. Drug Deliv. Rev."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1517\/17425247.2011.558081","article-title":"Liposomal vaccine delivery systems","volume":"8","author":"Korsholm","year":"2011","journal-title":"Expert Opin. Drug Deliv."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1016\/j.addr.2004.09.006","article-title":"ISCOMATRIX\u00ae adjuvant for antigen delivery","volume":"57","author":"Pearse","year":"2005","journal-title":"Adv. Drug Deliv. Rev."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"55","DOI":"10.4049\/jimmunol.1004114","article-title":"ISCOMATRIX Adjuvant Combines Immune Activation with Antigen Delivery to Dendritic Cells In Vivo Leading to Effective Cross-Priming of CD8+ T Cells","volume":"187","author":"Duewell","year":"2011","journal-title":"J. Immunol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1881","DOI":"10.1016\/j.vaccine.2010.12.129","article-title":"Nasal immunization with plasmid DNA encoding P6 protein and immunostimulatory complexes elicits nontypeable Haemophilus influenzae-specific long-term mucosal immune respons-es in the nasopharynx","volume":"29","author":"Kodama","year":"2011","journal-title":"Vaccine"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"282","DOI":"10.3109\/10611860903450015","article-title":"Evaluation of ISCOM vaccines for mucosal immunization against hepatitis B","volume":"18","author":"Pandey","year":"2009","journal-title":"J. Drug Target."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1007\/s13346-012-0085-z","article-title":"Strategies for intranasal delivery of vaccines","volume":"3","author":"Zaman","year":"2012","journal-title":"Drug Deliv. Transl. Res."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.2165\/11206860-000000000-00000","article-title":"Live Attenuated Influenza Vaccine (FluMist\u00ae; Fluenz\u2122)","volume":"71","author":"Carter","year":"2011","journal-title":"Drugs"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.drudis.2010.11.001","article-title":"Re-formulating drugs and vaccines for intranasal delivery: Maximum benefits for minimum risks?","volume":"16","author":"Watts","year":"2011","journal-title":"Drug Discov. Today"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1080\/21645515.2016.1239668","article-title":"Current prospects and future challenges for nasal vaccine delivery","volume":"13","author":"Yusuf","year":"2016","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_51","unstructured":"WHO (2021, January 25). Draft Landscape and Tracker of COVID-19 Candidate Vaccines. Available online: https:\/\/www.who.int\/publications\/m\/item\/draft-landscape-of-covid-19-candidate-vaccines."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"991","DOI":"10.12688\/f1000research.25998.1","article-title":"Development of vaccines for SARS-CoV-2","volume":"9","author":"Ng","year":"2020","journal-title":"F1000Research"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"624","DOI":"10.3390\/vaccines2030624","article-title":"Developments in Viral Vector-Based Vaccines","volume":"2","author":"Ura","year":"2014","journal-title":"Vaccines"},{"key":"ref_54","first-page":"1","article-title":"ChAdOx1 nCoV-19 vaccine prevents SARS-CoV-2 pneumonia in rhesus macaques","volume":"586","author":"Lambe","year":"2020","journal-title":"Nature"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"120686","DOI":"10.1016\/j.ijpharm.2021.120686","article-title":"Nasal vaccination against SARS-CoV-2: Synergistic or alternative to intramuscular vaccines?","volume":"603","author":"Tiboni","year":"2021","journal-title":"Int. J. Pharm."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"eabh0755","DOI":"10.1126\/scitranslmed.abh0755","article-title":"Intranasal ChAdOx1 nCoV-19\/AZD1222 vaccination reduces viral shedding after SARS-CoV-2 D614G challenge in preclinical models","volume":"13","author":"Purushotham","year":"2021","journal-title":"Sci. Transl. Med."},{"key":"ref_57","unstructured":"Douglas, A. (2021, August 12). A Study of Intranasal ChAdOx1 nCOV-19, Available online: https:\/\/clinicaltrials.gov\/ct2\/show\/NCT04816019."},{"key":"ref_58","unstructured":"(2021, August 12). A Phase I Clinical Trial of Influenza Virus Vector COVID-19 Vaccine for Intranasal Spray (DelNS1-2019-nCoV-RBD-OPT1). ChiCTR2000037782. Available online: www.chictr.org.cn\/showprojen.aspx?proj=55421."},{"key":"ref_59","unstructured":"Ye, X. (2021, August 12). A Phase II Clinical Trial of Influenza Virus Vector COVID-19 Vaccine for Intranasal Spray (DelNS1-2019-nCoV-RBD-OPT1). Available online: http:\/\/www.chictr.org.cn\/showprojen.aspx?proj=63754."},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"King, R.G., Silva-Sanchez, A., Peel, J.N., Botta, D., Meza-Perez, S., Allie, R., Schultz, M.D., Liu, M., Bradley, J.E., and Qiu, S. (2020). Single-dose intranasal administration of AdCOVID elicits systemic and mucosal immunity against SARS-CoV-2 in mice. bio-Rxiv.","DOI":"10.1101\/2020.10.10.331348"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.cell.2020.08.026","article-title":"A Single-Dose Intranasal ChAd Vaccine Protects Upper and Lower Respiratory Tracts against SARS-CoV-2","volume":"183","author":"Hassan","year":"2020","journal-title":"Cell"},{"key":"ref_62","first-page":"1","article-title":"Adenoviral vector vaccine platforms in the SARS-CoV-2 pandemic","volume":"6","author":"Lorincz","year":"2021","journal-title":"NPJ Vaccines"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"109400","DOI":"10.1016\/j.celrep.2021.109400","article-title":"A single intranasal or intramuscular immunization with chimpanzee adenovirus vectored SARS-CoV-2 vaccine protects against pneumonia in hamsters","volume":"36","author":"Bricker","year":"2020","journal-title":"Cell Rep."},{"key":"ref_64","unstructured":"(2021, August 12). Safety and Immunogenicity of an Intranasal SARS-CoV-2 Vaccine (BBV154) for COVID-19, Available online: https:\/\/www.clinicaltrials.gov\/ct2\/show\/NCT04751682."},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Li, K., Li, Z., Wohlford-Lenane, C., Meyerholz, D.K., Channappanavar, R., An, D., Perlman, S., McCray, P.B., and He, B. (2020). Single-Dose, Intranasal Immunization with Recombinant Parainfluenza Virus 5 Expressing Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Spike Protein Protects Mice from Fatal MERS-CoV Infection. mBio, 11.","DOI":"10.1128\/mBio.00554-20"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"eabi5246","DOI":"10.1126\/sciadv.abi5246","article-title":"Protection of K18-hACE2 mice and ferrets against SARS-CoV-2 challenge by a single-dose mucosal immunization with a parainfluenza virus 5\u2013based COVID-19 vaccine","volume":"7","author":"An","year":"2021","journal-title":"Sci. Adv."},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Wang, Y., Yang, C., Song, Y., Coleman, J.R., Stawowczyk, M., Tafrova, J., Tasker, S., Boltz, D., Baker, R., and Garcia, L. (2021). Scalable live-attenuated SARS-CoV-2 vaccine candidate demonstrates preclinical safety and efficacy. Proc. Natl. Acad. Sci. USA, 118.","DOI":"10.1073\/pnas.2102775118"},{"key":"ref_68","unstructured":"Bendel, D. (2021, August 12). Safety and Immunogenicity of COVI-VAC, a Live Attenuated Vaccine against COVID-19, Available online: https:\/\/clinicaltrials.gov\/ct2\/show\/NCT04619628."},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Tioni, M.F., Jordan, R., Pena, A.S., Garg, A., Wu, D., Phan, S.I., Cheng, X., Greenhouse, J., Orekov, T., and Valentin, D. (2021). One Mucosal Administration of a Live Attenuated Recombinant COVID-19 Vaccine Protects Nonhuman Primates from SARS-CoV-2. bioRxiv, Available online: https:\/\/www.biorxiv.org\/content\/10.1101\/2021.07.16.452733v2.","DOI":"10.1101\/2021.07.16.452733"},{"key":"ref_70","unstructured":"Medzihradsky, O. (2021, August 12). Safety and Immunogenicity of an Intranasal RSV Vaccine Expressing SARS-CoV-2 Spike Protein (COVID-19 Vaccine) in Adults, Available online: https:\/\/clinicaltrials.gov\/ct2\/show\/study\/NCT04798001."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41467-021-21639-w","article-title":"Immunogenicity and protective efficacy of inactivated SARS-CoV-2 vaccine candidate, BBV152 in rhesus macaques","volume":"12","author":"Yadav","year":"2021","journal-title":"Nat. Commun."},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"Shirvani, E., and Samal, S.K. (2020). Newcastle Disease Virus as a Vaccine Vector for SARS-CoV-2. Pathogens, 9.","DOI":"10.3390\/pathogens9080619"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"9788","DOI":"10.1073\/pnas.0703584104","article-title":"Newcastle disease virus, a host range-restricted virus, as a vaccine vector for intranasal immunization against emerging pathogens","volume":"104","author":"DiNapoli","year":"2007","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_74","doi-asserted-by":"crossref","unstructured":"Sun, W., Liu, Y., Amanat, F., Gonz\u00e1lez-Dom\u00ednguez, I., McCroskery, S., Slamanig, S., Coughlan, L., Rosado, V., Lemus, N., and Jangra, S. (2021). A Newcastle disease virus-vector expressing a prefusion-stabilized spike protein of SARS-CoV-2 induces protective immune responses against prototype virus and variants of concern in mice and hamsters. Res. Sq., Available online: https:\/\/www.biorxiv.org\/content\/10.1101\/2021.07.06.451301v1.","DOI":"10.1038\/s41467-021-26499-y"},{"key":"ref_75","unstructured":"De Leon, S.P. (2021, August 12). Study of a Live rNDV based Vaccine against COVID-19, Available online: https:\/\/clinicaltrials.gov\/ct2\/show\/NCT04871737."},{"key":"ref_76","unstructured":"Gonzalez Delgado, C.A. (2021, August 12). Adaptive Phase I\/II Clinical Trial, Randomized, of Parallel Groups, to Evaluate the Safety and Immunogenicity in Adults of Two Vaccine Candidates, Based on Recombinant RBD Subunits for the Prevention of COVID-19 in Regimens that Use the Nasal Route of Administration. Available online: https:\/\/rpcec.sld.cu\/en\/trials\/RPCEC00000345-En."},{"key":"ref_77","unstructured":"Mehrabadi, M.H.F., Kalantari, S., and Mokhberossaf, L. (2021, August 12). Phase I, Safety and Immunogenicity of Razi SARS-CoV-2 Recombinant Spike Protein Vaccine (Razi Cov Pars), in Healthy Adults Aged 18\u201355 Years; Parallel 4 Arms Design (Adjuvant Only and Three Vaccine Doses of 5, 10, and 20 \u00b5g\/200 \u00b5L); a Randomised, Double Blind, Clinical Trial. Available online: https:\/\/www.irct.ir\/trial\/52975."},{"key":"ref_78","unstructured":"Mehrabadi, M.H.F., Kalantari, S., and Mokhberossaf, L. (2021, August 12). Phase II, Safety and Immunogenicity of RAZI SARS-CoV-2 Recombinant Spike Protein Vaccine (RAZI Cov Pars) in Adults Aged 18\u201370 Years; a Randomised, Double Blind, Parallel 2 Arms Clinical Trial. Available online: https:\/\/en.irct.ir\/trial\/55238."},{"key":"ref_79","unstructured":"(2021, August 13). Development of an Intranasal Vaccine against COVID-19. Available online: https:\/\/www.wur.nl\/en\/Research-Results\/Research-Institutes\/Bioveterinary-Research\/show-bvr\/Development-of-an-intranasal-vaccine-against-COVID-19.htm."},{"key":"ref_80","unstructured":"(2021, August 13). OMV Platform Technology. Available online: https:\/\/www.intravacc.nl\/platforms\/outer-membrane-vesicles-platform."},{"key":"ref_81","unstructured":"(2021, August 13). Intravacc Announces Positive Pre-Clinical Data for Its SARS-CoV-2 Nose Spray Vaccine. Available online: https:\/\/www.intravacc.nl\/news\/intravacc-announces-positive-pre-clinical-data-intranasal-sars-cov-2-candidate-vaccine."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"6470","DOI":"10.1016\/j.vaccine.2019.08.077","article-title":"Intranasal nanoemul-sion-adjuvanted HSV-2 subunit vaccine is effective as a prophylactic and therapeutic vaccine using the guinea pig model of genital herpes","volume":"37","author":"Bernstein","year":"2019","journal-title":"Vaccine"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"6162","DOI":"10.1016\/j.vaccine.2019.08.071","article-title":"A nanoemulsion-adjuvanted intranasal H5N1 influenza vac-cine protects ferrets against homologous and heterologous H5N1 lethal challenge","volume":"37","author":"Smith","year":"2019","journal-title":"Vaccine"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"e0126120","DOI":"10.1371\/journal.pone.0126120","article-title":"Formulation, high throughput in vitro screening and in vivo functional characterization of nanoemul-sion-based intranasal vaccine adjuvants","volume":"10","author":"Wong","year":"2015","journal-title":"PLoS ONE"},{"key":"ref_85","unstructured":"(2021, August 13). Medigen and BlueWillow Biologics Partner to Develop Intranasal Vaccine for SARS-CoV-2. Available online: https:\/\/bluewillow.com\/medigen-and-bluewillow-biologics-partner-to-develop-intranasal-vaccine-for-sars-cov-2."},{"key":"ref_86","unstructured":"(2021, August 13). Finnish coronavirus vaccine developer Rokote Laboratories Finland Secures Significant Funding. Available online: https:\/\/www.uef.fi\/en\/article\/finnish-coronavirus-vaccine-developer-rokote-laboratories-finland-secures-significant-funding."},{"key":"ref_87","doi-asserted-by":"crossref","unstructured":"An, X., Martinez-Paniagua, M., Rezvan, A., Fathi, M., Singh, S., Biswas, S., Pourpak, M., Yee, C., Liu, X., and Varadarajan, N. (2020). Single-dose intranasal vaccination elicits systemic and mucosal immunity against SARS-CoV-2. bioRxiv, Available online: https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7386485.","DOI":"10.1101\/2020.07.23.212357"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1016\/j.chom.2020.12.010","article-title":"Intranasal vaccination with a lentiviral vector protects against SARS-CoV-2 in preclinical animal models","volume":"29","author":"Ku","year":"2020","journal-title":"Cell Host Microbe"},{"key":"ref_89","unstructured":"(2021, August 13). eTheRNA Launches an International Consortium and Starts Development of Cross-Strain Protective CoV-2 mRNA Vaccine for High Risk Populations. Available online: https:\/\/pipelinereview.com\/index.php\/2020032474098\/Vaccines\/eTheRNA-Launches-an-International-Consortium-and-Starts-Development-of-Cross-strain-Protective-CoV-2-mRNA-Vaccine-for-High-Risk-Populations.html."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1038\/s41586-021-03673-2","article-title":"Nasal delivery of an IgM offers broad protection from SARS-CoV-2 variants","volume":"595","author":"Ku","year":"2021","journal-title":"Nature"},{"key":"ref_91","doi-asserted-by":"crossref","unstructured":"Zhang, H., Yang, Z., Xiang, J., Cui, Z., Liu, J., and Liu, C. (2020). Intranasal administration of SARS-CoV-2 neutralizing human antibody prevents infection in mice. bioRxiv, Available online: https:\/\/www.biorxiv.org\/content\/10.1101\/2020.12.08.416677v1.","DOI":"10.1101\/2020.12.08.416677"},{"key":"ref_92","unstructured":"(2021, August 13). Eureka Therapeutics Announces Successful Preclinical Results of InvisiMask\u2122 Human Antibody Nasal Spray against SARS-CoV-2 Infection. Available online: https:\/\/www.eurekatherapeutics.com\/media\/press-releases\/121420."},{"key":"ref_93","unstructured":"(2021, August 13). Tiziana Life Sci PLC, Positive Data: Nasal Administration of Foralumab, RNS Number: 6337N. Available online: https:\/\/www.investegate.co.uk\/tiziana-life-sci-plc\/rns\/positive-data--nasal-administration-of-foralumab\/202102020700036337N\/."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/j.jinf.2021.05.009","article-title":"Clinical efficacy of nitric oxide nasal spray (NONS) for the treatment of mild COVID-19 infection","volume":"83","author":"Winchester","year":"2021","journal-title":"J. Infect."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"101734","DOI":"10.1016\/j.redox.2020.101734","article-title":"Mitigation of the replication of SARS-CoV-2 by nitric oxide in vitro","volume":"37","author":"Akaberi","year":"2020","journal-title":"Redox Biol."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"1774","DOI":"10.1039\/D0NJ03823G","article-title":"Nitric oxide as a therapeutic option for COVID-19 treatment: A concise perspective","volume":"45","author":"Mir","year":"2020","journal-title":"New J. Chem."},{"key":"ref_97","first-page":"1","article-title":"Inhaled nitric oxide for critically ill Covid-19 patients: A prospective study","volume":"24","author":"Huette","year":"2020","journal-title":"Crit. Care"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1111\/aas.13757","article-title":"Effects of inhaled nitric oxide in COVID-19\u2013induced ARDS \u2013 Is it worthwhile?","volume":"65","author":"Lotz","year":"2020","journal-title":"Acta Anaesthesiol. Scand."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"1531","DOI":"10.1086\/425357","article-title":"Inhalation of Nitric Oxide in the Treatment of Severe Acute Respiratory Syndrome: A Rescue Trial in Beijing","volume":"39","author":"Chen","year":"2004","journal-title":"Clin. Infect. Dis."},{"key":"ref_100","unstructured":"(2021, August 13). Covid-Busting Nasal Spray Begins UK Trials. Available online: https:\/\/apnews.com\/press-release\/business-wire\/science-business-public-health-products-and-services-coronavirus-pandemic-d6bf385141184700a2bde035c6b47678."},{"key":"ref_101","unstructured":"(2021, August 13). SaNOtize\u2019s \u201crevolutionary\u201d Covid-19 Nasal Spray Bolstered by Phase II Trial Data. Available online: https:\/\/www.clinicaltrialsarena.com\/news\/sanotize-nasal-spray-reduces-covid-19-viral-load-uk-clinical-trail."},{"key":"ref_102","doi-asserted-by":"crossref","unstructured":"Cannon, M., Westover, J.B., Bleher, R., Sanchez-Gonzalez, M.A., and Ferrer, G. (2020). In vitro analysis of the anti-viral potential of nasal spray constituents against SARS-CoV-2. bioRxiv, Available online: https:\/\/www.biorxiv.org\/content\/10.1101\/2020.12.02.408575v3.","DOI":"10.1101\/2020.12.02.408575"},{"key":"ref_103","doi-asserted-by":"crossref","unstructured":"Salli, K., Lehtinen, M.J., Tiihonen, K., and Ouwehand, A.C. (2019). Xylitol\u2019s Health Benefits beyond Dental Health: A Comprehensive Review. Nutrients, 11.","DOI":"10.3390\/nu11081813"},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1248\/bpb.b15-00773","article-title":"Ameliorating Effect of Dietary Xylitol on Human Respiratory Syncytial Virus (hRSV) Infection","volume":"39","author":"Xu","year":"2016","journal-title":"Biol. Pharm. Bull."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"e84633","DOI":"10.1371\/journal.pone.0084633","article-title":"Protective Effect of Dietary Xylitol on Influenza A Virus Infection","volume":"9","author":"Yin","year":"2014","journal-title":"PLOS ONE"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"118335","DOI":"10.1016\/j.lfs.2020.118335","article-title":"Correlation of D-xylose with severity and morbidity-related factors of COVID-19 and possible therapeutic use of D-xylose and antibiotics for COVID-19","volume":"260","author":"Cheudjeu","year":"2020","journal-title":"Life Sci."},{"key":"ref_107","first-page":"e11315","article-title":"Potential Role of Xylitol Plus Grapefruit Seed Extract Nasal Spray Solution in COVID-19: Case Series","volume":"12","author":"Go","year":"2020","journal-title":"Cureus"},{"key":"ref_108","doi-asserted-by":"crossref","unstructured":"Westover, J.B., Ferrer, G., Vazquez, H., Bethencourt-Mirabal, A., and Go, C.C. (2020). In Vitro Virucidal Effect of Intranasally Delivered Chlorpheniramine Maleate Compound Against Severe Acute Respiratory Syndrome Coronavirus 2. Cureus, 12.","DOI":"10.7759\/cureus.10501"},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/j.cell.2020.02.052","article-title":"SARS-CoV-2 Cell Entry Depends on ACE2 and TMPRSS2 and Is Blocked by a Clinically Proven Protease Inhibitor","volume":"181","author":"Hoffmann","year":"2020","journal-title":"Cell"},{"key":"ref_110","doi-asserted-by":"crossref","unstructured":"Wang, X., Xia, S., Wang, Q., Xu, W., Li, W., Lu, L., and Jiang, S. (2020). Broad-Spectrum Coronavirus Fusion Inhibitors to Combat COVID-19 and Other Emerging Coronavirus Diseases. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21113843"},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"1379","DOI":"10.1126\/science.abf4896","article-title":"Intranasal fusion inhibitory lipopeptide prevents direct-contact SARS-CoV-2 transmission in ferrets","volume":"371","author":"Schmitz","year":"2021","journal-title":"Science"},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"9855","DOI":"10.1021\/acsnano.8b01422","article-title":"Structure\u2013Stability\u2013Function Mechanistic Links in the Anti-Measles Virus Action of Tocopherol-Derivatized Peptide Nanoparticles","volume":"12","author":"Figueira","year":"2018","journal-title":"ACS Nano"},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"43610","DOI":"10.1038\/srep43610","article-title":"Broad spectrum antiviral activity for paramyxoviruses is modulated by biophysical properties of fusion inhibitory peptides","volume":"7","author":"Mathieu","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"2008304","DOI":"10.1002\/adma.202008304","article-title":"Formulation of a Composite Nasal Spray Enabling Enhanced Surface Coverage and Prophylaxis of SARS-COV-2","volume":"33","author":"Moakes","year":"2021","journal-title":"Adv. Mater."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/j.antiviral.2012.05.009","article-title":"Prevention of human enterovirus 71 infection by kappa carrageenan","volume":"95","author":"Chiu","year":"2012","journal-title":"Antivir. Res."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"2795","DOI":"10.3390\/md10122795","article-title":"The Antiviral Activities and Mechanisms of Marine Polysaccharides: An Overview","volume":"10","author":"Wang","year":"2012","journal-title":"Mar. Drugs"},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1016\/j.virol.2007.01.043","article-title":"Interference in dengue virus adsorption and uncoating by carrageenans","volume":"363","author":"Talarico","year":"2007","journal-title":"Virology"},{"key":"ref_118","doi-asserted-by":"crossref","unstructured":"Morokutti-Kurz, M., Fr\u00f6ba, M., Graf, P., Gro\u00dfe, M., Grassauer, A., Auth, J., Schubert, U., and Prieschl-Grassauer, E. (2021). Iota-carrageenan neutralizes SARS-CoV-2 and inhibits viral replication in vitro. PLOS ONE, 16.","DOI":"10.1371\/journal.pone.0237480"},{"key":"ref_119","unstructured":"(2021, August 14). Marinomed Biotech AG Announces Positive Clinical Data for Carragelose Lozenges against Respiratory viruses Including SARS-CoV-2. Available online: https:\/\/www.marinomed.com\/en\/news\/marinomed-biotech-ag-announces-positive-clinical-data-for-carragelose-lozenges-against-respiratory-viruses-including-sars-cov-2."},{"key":"ref_120","doi-asserted-by":"crossref","unstructured":"Figueroa, J., Lombardo, M., Dogliotti, A., Flynn, L.P., Giugliano, R.P., Simonelli, G., Valentini, R., Ramos, A., Romano, P., and Marcote, M. (2021). Efficacy of a nasal spray containing Iota-Carrageenan in the prophylaxis of COVID-19 in hospital person-nel dedicated to patients care with COVID-19 disease: A pragmatic multicenter, randomized, double-blind, place-bo-controlled trial (CARR-COV-02). medRxiv, 04.13.21255409.","DOI":"10.1101\/2021.04.13.21255409"},{"key":"ref_121","unstructured":"(2021, August 14). Antiseptic Saline Nasal Spray with MycoDelens and Yerba Santa. Available online: https:\/\/www.parnellpharm.com\/pretz-md."},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"103153","DOI":"10.1016\/j.ebiom.2020.103153","article-title":"Prophylactic intranasal administration of a TLR2\/6 agonist reduces upper respiratory tract viral shedding in a SARS-CoV-2 challenge ferret model","volume":"63","author":"Proud","year":"2020","journal-title":"EBioMedicine"},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"2001584","DOI":"10.1183\/13993003.01584-2020","article-title":"TLR2-mediated innate immune priming boosts lung anti-viral immunity","volume":"58","author":"Girkin","year":"2020","journal-title":"Eur. Respir. J."},{"key":"ref_124","doi-asserted-by":"crossref","unstructured":"Deliyannis, G., Wong, C.Y., McQuilten, H.A., Bachem, A., Clarke, M., Jia, X., Horrocks, K., Zeng, W., Girkin, J., and Scott, N.E. (2021). TLR2-mediated activation of innate responses in the upper airways confers antiviral protection of the lungs. JCI Insight, 6.","DOI":"10.1172\/jci.insight.140267"},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1038\/s41577-020-00477-9","article-title":"Regulation of immune responses by the airway epithelial cell landscape","volume":"21","author":"Hewitt","year":"2021","journal-title":"Nat. Rev. Immunol."},{"key":"ref_126","doi-asserted-by":"crossref","unstructured":"Vetter, P., Eberhardt, C.S., Meyer, B., Murillo, P.A.M., Torriani, G., Pigny, F., Lemeille, S., Cordey, S., Laubscher, F., and Vu, D.-L. (2020). Daily Viral Kinetics and Innate and Adaptive Immune Response Assessment in COVID-19: A Case Series. mSphere, 5.","DOI":"10.1128\/mSphere.00827-20"},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"104787","DOI":"10.1016\/j.antiviral.2020.104787","article-title":"The FDA-approved drug ivermectin inhibits the replication of SARS-CoV-2 in vitro","volume":"178","author":"Caly","year":"2020","journal-title":"Antivir. Res."},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"3023","DOI":"10.21873\/invivo.12134","article-title":"Ivermectin docks to the SARS-CoV-2 spike receptor-binding domain attached to ACE2","volume":"34","author":"Lehrer","year":"2020","journal-title":"In Vivo"},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"4063","DOI":"10.2147\/IJN.S313093","article-title":"Clinical, Biochemical and Molecular Evaluations of Ivermectin Mucoadhesive Nanosuspension Nasal Spray in Reducing Upper Respiratory Symptoms of Mild COVID-19","volume":"16","author":"Aref","year":"2021","journal-title":"Int. J. Nanomed."},{"key":"ref_130","doi-asserted-by":"crossref","unstructured":"Errecalde, J., Lifschitz, A., Vecchioli, G., Ceballos, L., Errecalde, F., Ballent, M., Mar\u00edn, G., Daniele, M., Turic, E., and Spitzer, E. (2020). Ivermectin repurposing for COVID-19 therapy: Safety and pharmacokinetic assessment of a novel nasal spray formulation in a pig model. bioRxiv, 10.23.352831. Available online: https:\/\/www.biorxiv.org\/content\/10.1101\/2020.10.23.352831v1.","DOI":"10.1101\/2020.10.23.352831"},{"key":"ref_131","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1038\/s41422-020-0282-0","article-title":"Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro","volume":"30","author":"Wang","year":"2020","journal-title":"Cell Res."},{"key":"ref_132","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1093\/cid\/ciaa237","article-title":"In Vitro Antiviral Activity and Projection of Optimized Dosing Design of Hydroxychloroquine for the Treatment of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)","volume":"71","author":"Yao","year":"2020","journal-title":"Clin. Infect. Dis."},{"key":"ref_133","doi-asserted-by":"crossref","first-page":"151","DOI":"10.4103\/ijmr.IJMR_3665_20","article-title":"Chloroquine nasal drops in asymptomatic & mild COVID-19: An exploratory randomized clinical trial","volume":"153","author":"Thakar","year":"2021","journal-title":"Indian J. Med Res."},{"key":"ref_134","first-page":"100084","article-title":"A randomized, double-blind, placebo-controlled phase 1 trial of inhaled and intranasal niclosamide: A broad spectrum antiviral candidate for treatment of COVID-19","volume":"4","author":"Backer","year":"2021","journal-title":"Lancet Reg. Health\u2014Eur."},{"key":"ref_135","doi-asserted-by":"crossref","unstructured":"Kirk-Bayley, J., Challacombe, S., Sunkaraneni, V., and Combes, J. (2020). The use of povidone iodine nasal spray and mouthwash during the current COVID-19 pandemic may protect healthcare workers and reduce cross infection. SSRN Electron. J., Available online: https:\/\/papers.ssrn.com\/sol3\/papers.cfm?abstract_id=3563092#maincontent.","DOI":"10.2139\/ssrn.3563092"},{"key":"ref_136","doi-asserted-by":"crossref","first-page":"192S","DOI":"10.1177\/0145561320957237","article-title":"Efficacy of Povidone-Iodine Nasal and Oral Antiseptic Preparations Against Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV-2)","volume":"100","author":"Pelletier","year":"2020","journal-title":"Ear Nose Throat J."},{"key":"ref_137","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1001\/jamaoto.2020.5490","article-title":"Povidone Iodine Mouthwash, Gargle, and Nasal Spray to Reduce Nasopharyngeal Viral Load in Patients With COVID-19","volume":"147","author":"Guenezan","year":"2021","journal-title":"JAMA Otolaryngol. Neck Surg."},{"key":"ref_138","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13063-020-04963-2","article-title":"Virucidal effect of povidone iodine on COVID-19 in the nasopharynx: A structured summary of a study protocol for an open-label randomized clinical trial","volume":"22","author":"Hasan","year":"2021","journal-title":"Trials"},{"key":"ref_139","unstructured":"Lyon, M. (2021, August 11). Nasal irrigation to reduce COVID-19 morbidity, Available online: https:\/\/clinicaltrials.gov\/ct2\/show\/NCT04559035."},{"key":"ref_140","unstructured":"Khan, A. (2021, August 11). SINUS WASH pilot study in adults testing positive for COVID-19, Available online: https:\/\/clinicaltrials.gov\/ct2\/show\/NCT04393792."},{"key":"ref_141","unstructured":"Arefin, M.K. (2021, August 11). Virucidal Effect of PVP-I on COVID-19 and as well as Safety of its Application on Nasopharynx & Oropharynx (COVID-19), Available online: https:\/\/clinicaltrials.gov\/ct2\/show\/NCT04872686."},{"key":"ref_142","unstructured":"Barone, S.B. (2021, August 11). Halodine Nasal Antiseptic in Patients With COVID-19, Available online: https:\/\/clinicaltrials.gov\/ct2\/show\/NCT04517188."},{"key":"ref_143","unstructured":"Perzynski, J., and Zimbric, S. (2021, August 11). Using Naso-Oropharyngeal Antiseptic Decolonization to Reduce COVID-19 Viral Shedding (SHIELD), Available online: https:\/\/clinicaltrials.gov\/ct2\/show\/NCT04478019."},{"key":"ref_144","unstructured":"Nayak, J.V., and Vukkadala, N. (2021, August 11). PVP-I Nasal Sprays and SARS-CoV-2 Nasopharyngeal Titers (for COVID-19), Available online: https:\/\/clinicaltrials.gov\/ct2\/show\/NCT04347954."},{"key":"ref_145","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1177\/0194599820933170","article-title":"Intranasal Antiviral Drug Delivery and Coronavirus Disease 2019 (COVID-19): A State of the Art Review","volume":"163","author":"Higgins","year":"2020","journal-title":"Otolaryngol. Neck Surg."},{"key":"ref_146","doi-asserted-by":"crossref","first-page":"1862","DOI":"10.1097\/MLG.0b013e31817f4d34","article-title":"Effects of a Low Concentration Hypochlorous Acid Nasal Irrigation Solution on Bacteria, Fungi, and Virus","volume":"118","author":"Kim","year":"2008","journal-title":"Laryngoscope"},{"key":"ref_147","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2018\/8568694","article-title":"Antibacterial Effect of Hypochlorous Acid Solution on Nasal Discharge from Patients with Chronic Rhinosinusitis","volume":"2018","author":"Wu","year":"2018","journal-title":"Int. J. Otolaryngol."},{"key":"ref_148","doi-asserted-by":"crossref","unstructured":"Giarratana, N., Rajan, B., Kamala, K., Mendenhall, M., and Reiner, G. (2021). A sprayable Acid-Oxidizing solution containing hypochlorous acid (AOS2020) efficiently and safely inactivates SARS-Cov-2: A new potential solution for upper respiratory tract hygiene. Eur. Arch. Oto-Rhino-Laryngol., 1\u20135.","DOI":"10.1007\/s00405-021-06644-5"},{"key":"ref_149","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1111\/jcpe.12428","article-title":"A randomized trial of ethyl lauroyl arginate-containing mouthrinse in the control of gingivitis","volume":"42","author":"Gallob","year":"2015","journal-title":"J. Clin. Periodontol."},{"key":"ref_150","unstructured":"(2021, August 11). How Does COVIXYL-V Nasal Spray Work?. Available online: https:\/\/salvacion-usa.com\/facts-about-salvacions-product."},{"key":"ref_151","doi-asserted-by":"crossref","unstructured":"Strauss, R., Jawhari, N., Attaway, A.H., Hu, B., Jehi, L., Milinovich, A., Ortega, V.E., and Zein, J.G. (2021). Intranasal Corticosteroids Are Associated with Better Outcomes in Coronavirus Disease 2019. J. Allergy Clin. Immunol. Pract.","DOI":"10.1016\/j.jaip.2021.08.007"},{"key":"ref_152","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1007\/s43440-021-00235-1","article-title":"Evaluation of effects of chronic nasal steroid use on rhinological symptoms of COVID-19 with SNOT-22 questionnaire","volume":"73","year":"2021","journal-title":"Pharmacol. Rep."},{"key":"ref_153","doi-asserted-by":"crossref","first-page":"102884","DOI":"10.1016\/j.amjoto.2020.102884","article-title":"Corticosteroid nasal spray for recovery of smell sensation in COVID-19 patients: A randomized controlled trial","volume":"42","author":"Abdelalim","year":"2021","journal-title":"Am. J. Otolaryngol."},{"key":"ref_154","unstructured":"(2021, September 16). Randomized Clinical Trial of Intranasal Dexamethasone as an Adjuvant in Patients With COVID-19, Available online: https:\/\/clinicaltrials.gov\/ct2\/show\/NCT04513184."},{"key":"ref_155","doi-asserted-by":"crossref","unstructured":"Timurkaan, M., and Y\u0131ld\u0131r\u0131m, Y.S.S. (2021, August 14). Can Topical Nasal Steroid Prevent the Loss of Smell in Covid-19?. Available online: https:\/\/www.researchsquare.com\/article\/rs-672443\/v1.","DOI":"10.21203\/rs.3.rs-672443\/v1"},{"key":"ref_156","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1111\/cei.13018","article-title":"Intranasal delivery of dexamethasone efficiently controls LPS-induced murine neuroinflammation","volume":"190","author":"Meneses","year":"2017","journal-title":"Clin. Exp. Immunol."},{"key":"ref_157","doi-asserted-by":"crossref","first-page":"1214","DOI":"10.1016\/j.jaci.2020.06.038","article-title":"COVID-19: Start with the nose","volume":"146","author":"Lipworth","year":"2020","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_158","unstructured":"Shukla, S.C. (2020). ACE2 expression in allergic airway disease may decrease the risk and severity of COVID-19. Eur. Arch. Oto-Rhino-Laryngol., 1\u20134."}],"container-title":["Pharmaceutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4923\/13\/10\/1612\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:09:08Z","timestamp":1760166548000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4923\/13\/10\/1612"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,3]]},"references-count":158,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2021,10]]}},"alternative-id":["pharmaceutics13101612"],"URL":"https:\/\/doi.org\/10.3390\/pharmaceutics13101612","relation":{},"ISSN":["1999-4923"],"issn-type":[{"value":"1999-4923","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,3]]}}}