Effect of antimicrobial mouthwashes on the detection of SARS-COV-2 in Ghana

The COVID-19 pandemic has challenged all facets of society, especially the health sector in Africa. Studies have investigated viral shedding dynamics in symptomatic patients, however, not much has been done for asymptomatic patients. For the health sector to be able to provide efficient care in a safe environment, it is important to determine how long asymptomatic individuals shed viable viruses. Also, evidence-based directions are needed to reduce the risk of infecting staff and other clinic attendees. This is critical since most persons infected with SARS-CoV-2 in Africa are asymptomatic. Many anti-microbial mouthwashes have been proven to be effective against oral pathogens. However, these are yet to be proven to reduce the spread of SARS-CoV-2. This study proposes to investigate how long it takes for SARS-CoV-2 infected asymptomatic persons to shed viable virus. It also seeks to evaluate among these patients the effect of a one-time mouth rinsing with four different mouthwashes on the detectable viral load of SARS-CoV-2 and to determine how long it takes for SARS-CoV-2 viral load to remain low after using the mouth rinse. Participants confirmed to have SARS-CoV-2 will be randomly assigned to receive one of four different mouth rinses. The viral load would then be reevaluated immediately post rinsing, and at 15 minutes, 30 minutes and one hour for changes in the viral load. This study will inform guidelines regarding pretreatment of patients before being attended to by health workers, to reduce the spread of SARS-CoV-2. Expected Outputs (1) Critical data on shedding dynamics among asymptomatic persons infected with SARSCOV-2. This may help change isolation rules and give confidence to caregivers. (2) Information on effects of mouthwashes on Covid-19. The study will show whether or not commonly available mouthwashes can temporarily reduce the viral load of SARS-CoV-2. If so, that agent could serve as standard of care gargle prior to patient-provider encounter in clinical settings. (3) Training of students in translational research. Another key area that this proposal will be impactful is in capacity building in clinical studies for young postdoctoral fellows and technicians.