Background: Role of microaspiration of mucus mixed with SARS-CoV-2 (severe acute respiratory syndrome corona virus 2) causing pneumonia is lacking in searched literature. Recently some authors have emphasized on microaspiration. SARS-CoV-2 primarily replicates in nasal mucosa and sheds in nasal mucus which travels down as microaspiration and causes pneumonia. We aimed to evaluate the efficacy of normal saline nasal spray and gargle (NSNSG) to wash off SARS-CoV-2 from nasal and pharyngeal mucosa to prevent microaspiration and pneumonia.
Methods: From RT-PCR (reverse transcriptase polymerase chain reaction) report, we selected 61 patients for study group and 64 patients for control, having higher virion load; cycle threshold (Ct) value 25 or less. Patients in study group were trained with NSNSG. We reviewed HRCT (high resolution computed tomogram) of lung in 56 patients of both groups for severity score in lung and were compared with initial HRCT.
Results: Twenty nine out of 61 (47%) of study group significantly (p=0·02) became negative following NSNSG compared to 17 out of 64 patients (26%) of control. Severity score (SS) in 31 out of 34 patients (91%) either decreased or became static in study group. In control group, 14 out of 22 patients (63%) also showed same findings. Nevertheless, study group significantly improved (p=0·028) in SS.
Conclusions: NSNSG significantly washes off SARS-CoV-2 from nasal cavity and pharynx and prevents microaspiration of SARS-CoV-2 in lung alveoli.
Trial Registration No: CTRI/2020/08/027465