Gargling with Salt Water May Help Prevent Covid Hospitalization: Study

By Dr Frank Yap, M.D. -

According to research presented at the annual meeting of the American College of Allergy, Asthma and Immunology (ACAAI) in early November 2023, gargling and rinsing your nasal passages with a simple saline solution can ease the respiratory symptoms of COVID-19 and reduce your risk of hospitalization.

The results have not yet been published in a peer-reviewed medical journal. As reported in an ACAAI press release,1 both high- and low-dose saline regimens, consisting of gargling and nasal rinsing four times a day for 14 days, were associated with significantly lower hospitalization rates for COVID-19 infections compared to the reference population.

Simple Technique to Lower Your Hospitalization Risk

Between 2020 and 2022, 55 individuals between the ages of 18 and 65 who tested positive for SARS-CoV-2 infection were randomly assigned to use either a high- or low-dose saline solution. Outcomes were compared to a reference group of 9,398 patients who also had COVID but didn’t gargle or rinse their nasal passages. All had similar rates of vaccination, including controls.

The low-dose group used 2.13 grams of salt dissolved in 8 ounces of warm water, while the high-dose group used 6 grams of salt. They were instructed to gargle and rinse their nasal passages with the solution four times a day for 14 days.

The primary outcomes included frequency and duration of symptoms associated with SARS-CoV-2 infection. Secondary outcomes included hospital or ICU admission, mechanical ventilatory support and death.

Primary and secondary outcomes were very similar between the two treatment groups, but significantly lower than the control group. The hospitalization rate among those using the low-dose saline regimen was 18.5%. In the high-dose group, it was 21.4%. The reference population, meanwhile, had a hospitalization rate of 58.8%. No significant differences were noted in the other outcomes. Co-author Dr. Jimmy Espinoza commented on the results:

"We found that both saline regimens appear to be associated with lower hospitalization rates compared to controls in SARS-CoV-2 infections2 ... It’s a very simple intervention that is universally available, cheap and easy to use. I think it can make a difference, especially when it comes to comfort." (3)

Nasal Irrigation and Gargling Speeds Recovery From Common Cold

Studies have shown similar benefits for other respiratory ailments as well. For example, nasal irrigation and gargling with hypertonic saline has been shown to reduce the duration of the common cold by 1.9 days and reduce transmission within the household by 35% when done within 48 hours of symptom onset.4

Gargling and flushing your sinuses helps prevent respiratory infections and speeds recovery by killing and flushing out viruses, thereby lowering your viral load.

In most respiratory infections, including COVID-19, the viral load is greatest in the sinuses and nasal cavity. Regularly rinsing your sinuses therefore makes sense since it would help clear out the pathogen and prevent it from gaining a strong foothold and migrating into your lungs.

Gargling and flushing your sinuses helps prevent respiratory infections and speeds recovery by killing and flushing out viruses, thereby lowering your viral load.

In most respiratory infections, including COVID-19, the viral load is greatest in the sinuses and nasal cavity. Regularly rinsing your sinuses therefore makes sense since it would help clear out the pathogen and prevent it from gaining a strong foothold and migrating into your lungs.

‘How to’ Pointers

The easiest way to do this is to buy a ready-made sterile saline solution. If you use tap water, it’s best to boil it first to rid the water of potential contaminants. I also recommend using a natural, unprocessed salt for the same reason. Heating the water isn’t necessary to dissolve the salt, but it will accelerate the process. Make sure the water is at your body temperature before you use it.

Stir in one-quarter to half a teaspoon of salt and let the water cool until it’s lukewarm. If you want, you could also add half a teaspoon of baking soda. Higher amounts of salt can be helpful if you’re severely congested, but it may burn a bit.

Gargle for one minute, then use the remainder of the water to rinse your nasal passages using a neti pot or NeilMed sinus rinse bottle. The water pressure you get from a sinus rinse bottle can provide a more effective flush. If higher pressure is uncomfortable, a neti pot, which relies on gravity, may be a more comfortable choice.

Povidone-Iodine Alternative

You can also do nasal rinses and gargle with povidone-iodine instead of saline. For a nasal rinse, simply swap out the salt water or store-bought saline with half a teaspoon of povidone-iodine in 8 ounces of lukewarm water.

Povidone-iodine has been shown to effectively kill not only Klebsiella pneumoniae and Streptococcus pneumoniae bacteria, but to also rapidly inactivate SARS-CoV, MERS-CoV, H1N1 influenza virus A and rotavirus after just 15 seconds of exposure.5

The mixture used in that study — 7% povidone-iodine diluted 1-to-30, which equates to a total concentration of 0.23% povidone-iodine — inactivated over 99% of the coronaviruses causing SARS and MERS.

Other research has shown that high-risk patients with COVID-19 who irrigated with povidone-iodine reduced their risk of hospitalization by eight times compared to the national rate.6

Gargling is also beneficial. In one study, patients who gargled with a povidone-iodine solution at least four times a day for several months up to two years significantly lowered their incidence of chronic respiratory infections.7

If you want to use povidone-iodine for gargling, be sure to look for solutions formulated specifically as a sore throat gargle, such as Betadine. Do not use products intended for cuts and wound care. Povidone-iodine solutions sold as skin disinfectants are not suitable for gargling as they contain potentially harmful ingredients that should not be ingested.

There are 20 published studies supporting povidone-iodine for COVID-19. You can check out the list at c19pvpi.com (constantly updated).

Povidone-iodine is ranked no. 3 in this COVID-19 early treatment death-rate league table below.


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