New Study: Gargling with Salt Water May Help Prevent Covid Hospitalization

Hospitalization rates in people with saline regimens significantly lower than in reference population

ANAHEIM, Calif. (Nov. 9, 2023) – As Covid and its health effects move into a fourth year, those who become infected may be searching for remedies to improve their respiratory symptoms and keep them out of the hospital. A new study being presented at this year’s American College of Allergy, Asthma is a chronic, inflammatory lung disease characterized by recurrent breathing problems. People with asthma have acute episodes where the air passages in their lungs get narrower, and breathing becomes more difficult. Sometimes episodes of asthma are triggered by allergens, although infection, exercise, cold air and other factors are also important triggers." rel="tooltip" style="box-sizing: border-box; border-width: 0px 0px 1px; border-top-style: initial; border-right-style: initial; border-bottom-style: dotted; border-left-style: initial; border-top-color: initial; border-right-color: initial; border-bottom-color: rgb(153, 153, 153); border-left-color: initial; border-image: initial; cursor: help; display: inline-block; width: 17px; margin-right: 0.1em; text-align: center; font-stretch: normal; position: relative; line-height: 1; height: 17px; border-radius: 8.5px; box-shadow: none; vertical-align: top; transition: all 0.2s ease-in-out 0s !important; text-decoration-color: rgb(240, 100, 1) !important; font-family: "Helvetica Neue LT W05_65 Medium", Helvetica, Arial, sans-serif !important; text-rendering: optimizelegibility !important; -webkit-font-smoothing: antialiased !important; color: rgb(240, 100, 1) !important;">Asthma and Immunology (ACAAI) Annual Scientific Meeting in Anaheim, Calif. determined that both a low- and high-dose saline regimen appeared to be associated with lower hospitalization rates compared to controls in SARS-CoV-2 infections.

“Between 2020 and 2022, individuals aged 18-65 years with positive PCR test for SARS-CoV-2 infection were randomly selected to undergo low- or high-dose saline regimens for 14 days,” says Sebastian Espinoza, lead author of the study. “The low- and high-saline solutions consisted of 2.13 grams and 6 grams of salt dissolved in 8 ounces of warm water, respectively. Gargling and nasal rinsing was done four times a day for 14 days. Primary outcomes included frequency and duration of symptoms associated with SARS-CoV-2 infection; secondary outcomes included hospital or ICU admission, mechanical ventilatory support, or death. Exclusion criteria were chronic hypertension or participation in another interventional study. Those on the low- and high-dose saline solutions, as well as those in the reference population, had similar rates of vaccination.”

58 individuals were allocated to either the low (27) or high (28) saline regimens; 3 were lost to follow-up. There were no significant differences in the primary or secondary outcomes of the study between these two groups. During the study period, 9,398 individuals with positive SARS-CoV-2 infection were evaluated and were the reference population. The hospitalization rates in the low- (18.5%) and high- (21.4%) saline regimens were significantly lower than in the reference population (58.8%.) No significant differences were noted in other outcomes among these groups.

“Our goal was to examine saline nasal irrigation and gargling for possible association to improved respiratory symptoms associated with coronavirus infection,” says Jimmy Espinoza, MD, co-author of the study. “We found that both saline regimens appear to be associated with lower hospitalization rates compared to controls in SARS-CoV-2 infections. We hope more studies can be done to further investigate the association.”

https://acaai.org/news/new-study-gargling-with-salt-water-may-help-prevent-covid-hospitalization/

 

Interesting article. What's appealing about using salt water gargles and nasal irrigation to mitigate covid symptoms is that these treatments are easy, inexpensive, and shouldn't have much, if any, side effects.

Of course, with nasal irrigation, you have to use common sense and use either distilled water or boiled, cooled tap water. It's recommended to boil tap water for at least 5 minutes to kill microorganisms. Distilled water does not require boiling.

Also, it's important to rinse with purified salt. I use packets for nasal irrigation since they are convenient and include a small amount of sodium bicarbonate to make the PH more comfortable for rinsing. Xlear, the packet I use, also has xylitol, which my ENT recommends to help prevent sinus infections.

 

I haven't read this study before but have seen similar data elsewhere, for example here: https://pubmed.ncbi.nlm.nih.gov/36007135/.

Is this really the case? Carmen Scheibenbogen just advises using regular tap water with Emser Naselspülsalz (which seems a bit like a pharmaceutical marketing term for relatively normal salt).

 

Oh wow. Sounds a bit alarmist too me, but then again you don't want to be doing more harm than good. I suppose it'll also depend on where one is living/the quality of tapwater (apparently the main problem is Naegleria fowleri). Allegedly the FDA recommends boiling the water or using distilled water (based on this recommendation a study was conducted to test which method could potentially be safer), in central Europe using regular tap water seems to be the usual advice.

During my current Covid infection I've been using nasal irrigation with standard tap water. Boiling the water or prepared nasal wash in sterile bottles certainly sounds like it could reduce some potential risks or at least seems "cleaner", but it's also too large of a hurdle for me, respectively for my partner.

In either case I don't have any expertise to say anything about this.

 

I have done twice or more nasal irrigations followed by a steroid nasal spray for non-allergic rhinitis.

Used to use tap water until I read about those nasty microbes in ponds that very occasionally get up the noses of the unfortunate swimmer.

I boil tap water for a good 5 minutes and refrigerate. Microwave to reheat and add non-iodized salt w/pinch of baking soda. If traveling, distilled water plus added salt.

The effect of the nasal steroid on the nasal lining--I don't know how much it affects IgA levels. The consensus in the mid-pandemic was: not important, use the steroid spray.

 

Isn't gargling with salty water otherwise known, traditionally, as 'drowning'.

 

I couldn't find, from a quick search of the paper, whether or not patients swallowed the saline. This could be important if in COVID, as in ME, there is a tendency to hyponatraemia.

 

The idea of the general public doing that as a preventative measure is nonsense, but if this has its merits, it could make sense to try in hospital settings or long-term care facilities.

Although "may help" remains a useless standard to make decisions about anything.

 

My mother used to swear by gargling with salt water when I had mouth ulcers or tonsillitis or a sore throat as a child. @MeSci I've never deliberately swallowed the salt water. Salt water has been used in the past for making people vomit, so it wouldn't appeal to me!

I do still use salt water gargling very occasionally but I have found a couple of options that work better for me, so it is rare. I'm not convinced that salt water would help with Covid, although it might help if cleaning teeth was too painful for some reason. It might help to reduce viral or bacterial count in the mouth if normal oral hygiene was not possible, but I'm only guessing.