Obat Kumur Povidone Iodine sebagai Tindakan Pra-Prosedural untuk Mengurangi Risiko Penularan SARS-CoV-2 dalam Praktik Kedokteran Gigi
Authors: Rakhman Latifah Fitriani 
Published: August 2020

Latar Belakang: Kasus COVID-19 menurut WHO per 25 Juli 2020 adalah 15.581.009 kasus terkonfirmasi positif, 635.173 kasus kematian, mencakup 216 negara/wilayah di dunia. Sebuah artikel New York Times menyebut dokter gigi sebagai profesi yang paling rentan terpapar infeksi nosokomial virus SARS-CoV-2. Air liur diketahui mengandung viral load SARS-CoV-2 yang tinggi hingga 1,2×108/per ml. Povidone iodine (PVP-I) menunjukkan aktivitas in vitro terhadap berbagai virus, termasuk SARS-CoV dan MERS. Studi terbaru membuktikan homologi SARS-CoV-2 dengan SARS-CoV mencapai 82%, sehingga ada optimisme bahwa PVP-I juga efektif terhadap SARS-CoV-2 seperti halnya SARS-CoV yang terbukti dapat dinonaktifkan dengan PVP-I.

Tujuan: Mengulas dan melaporkan hasil penelitian terkait penggunaan PVP-I oral terhadap SARS-CoV-2 dalam kasus klinis dan penelitian in vitro.

Metode: Article review dilakukan dengan mengumpulkan jurnal ilmiah secara online menggunakan keyword “povidone iodine”, “povidone iodine covid-19”, “povidone iodine oral rinse”, dan “povidone iodine in dental practice”. Sumber data primer dengan kriteria seleksi data kemudian diskrining. Kriteria inklusi yaitu jurnal yang diterbitkan selama lima tahun terakhir.

Hasil: Hasil studi in vitro dengan uji viral kill time PVP-I 1.0% terhadap sel Vero-E6 yang dilakukan oleh Eggers, et.al. menunjukkan 99.99% efektif terhadap SARS-CoV-2 dalam waktu 30 detik dari kontak. Sedangkan Paranjape, et.al. mengusulkan penggunaan 0.5% PVP-I sebagai desinfeksi oral. Keduanya telah dilakukan uji toksisitas dan hasilnya tidak ada alergi yang dilaporkan.

Simpulan: PVP-I dapat diberikan sebagai upaya pra-prosedural tindakan perawatan gigi yaitu meminta pasien berkumur dengan 1.0% PVP-I 10 ml selama 30 detik sebelum perawatan gigi dimulai. PVP-I telah terbukti sebagai terapi yang aman digunakan sebagai obat kumur.

Kata kunci: SARS-CoV-2, povidone iodine, obat kumur, pra-prosedural, praktik dokter gigi

 

Abstract

The incidence of COVID-19 has increased in a short time. The COVID-19 case according to WHO as of July 25, 2020 were 15,581,009 positive confirmed cases, 635,173 fatal cases. It occurs in 216 countries/regions in the world. A New York Times article referred dentists as the profession most vulnerable to nosocomial infection of the SARS-CoV-2 virus. Saliva is known to contain a high SARS-CoV-2 viral load of up to 1.2×108/per ml, therefore, the dentist is categorized as high risk subject. Povidone-iodine (PVP-I) shows in vitro activity against various viruses, including SARS-CoV and MERS. Recent studies prove the homology of SARS-CoV-2 with SARS-CoV reaches 82%. With high homology rates, there is optimism that PVP-I is also effective against SARS-CoV-2 as well as SARS-CoV which is proven to be deactivated with PVP-I.

Objective: To review the research results related to the use of oral PVP-I against SARS-CoV-2 in clinical case and in vitro research.

Method: Article review was conducted by collecting scientific journals online using certain keywords: “povidone iodine”, “povidone iodine covid-19”, “povidone iodine oral rinse”, and “povidone iodine in dental practice”. Primary data sources were chosen with data selection criteria and then screened. Inclusion criteria are journals published during the last five years.

Results: In vitro study results with a 1.0% PVP-I viral kill time test of Vero-E6 (American Type Culture Collection) cells, conducted by Eggers, et.al. showed 99.99% virucidal activity against SARS-CoV-2 within 30 seconds of contact. While Paranjape, et.al. propose the use of 0.5% PVP-I as an oral disinfection. Both have been tested for toxicity and no allergic results have been reported.

Conclusion: PVP-I can be safely administered as a pre-procedural in dental treatment, which is intended for use in the patient, i.e to rinse with 1.0% PVP-I 10 ml for 30 seconds before dental treatment. PVP-I has been proven as a safe therapy as a mouthwash.

Keywords: SARS-CoV-2, povidone iodine, mouthwash, pre-procedural, dental practice