Evaluation of silver nanoparticles for the prevention of SARS-CoV-2 infection in health workers: In vitro and in vivo

  1. Horacio Almanza-Reyes
  2. Sandra Moreno
  3. Ismael Plascencia-López
  4. Martha Alvarado-Vera
  5. Leslie Patrón-Romero
  6. Belén Borrego
  7. Alberto Reyes-Escamilla
  8. Daniel Valencia-Manzo
  9. Alejandro Brun
  10. Alexey Pestryakov
  11. Nina Bogdanchikova

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Abstract

SARS-CoV-2 infection in hospital areas is of a particular concern, since the close interaction between health care personnel and patients diagnosed with COVID-19, which allows virus to be easily spread between them and subsequently to their families and communities. Preventing SARS-CoV-2 infection among healthcare personnel is essential to reduce the frequency of infections and outbreaks during the pandemic considering that they work in high-risk areas. In this research, silver nanoparticles (AgNPs) were tested in vitro and shown to have an inhibitory effect on SARS-CoV-2 infection in cultured cells. Subsequently, we assess the effects of mouthwash and nose rinse with ARGOVIT ® silver nanoparticles (AgNPs), in the prevention of SARS-CoV-2 contagion in health workers consider as high-risk group of acquiring the infection in the General Tijuana Hospital, Mexico, a hospital for the exclusive recruitment of patients diagnosed with COVID-19. We present a prospective randomized study of 231 participants that was carried out for 9 weeks (during the declaration of a pandemic). The "experimental" group was instructed to do mouthwash and nose rinse with the AgNPs solution; the "control" group was instructed to do mouthwashes and nose rinse in a conventional way. The incidence of SARS-CoV-2 infection was significantly lower in the "experimental" group (two participants of 114, 1.8%) compared to the "control" group (thirty-three participants of 117, 28.2%), with an 84.8% efficiency. We conclude that the mouth and nasal rinse with AgNPs helps in the prevention of SARS-CoV-2 infection in health personnel who are exposed to patients diagnosed with COVID-19.

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  1. Version published to 10.1371/journal.pone.0256401
  2. ScreenIT

    SciScore for 10.1101/2021.05.20.21256197: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: Ethical considerations: The in vivo study was approved by the Research Ethics Committee of General Tijuana Hospital of the Institute of Public Health Services of the State of Baja California with favorable opinion number CONBIOETICA-02-CEI-001-20170 and was conducted in accordance with the Declaration of Helsinki.
    Consent: Signed consent was obtained from all participants.
    Sex as a biological variableMen and women were included among the participants, ranging from 18 to 65 years of age, and various occupations.
    RandomizationA 2-group randomized parallel study was conducted to compare the efficacy of mouthwash and nose rinse with the AgNPs 1 wt. % (0.6 mg of metallic Ag per mL) or direct spray to the oral cavity (experimental group); the second group was instructed to do mouthwash and nose rinse in a conventional way (control group).
    Blindingnot detected.
    Power Analysisnot detected.
    Cell Line Authenticationnot detected.

    Table 2: Resources

    Experimental Models: Cell Lines
    SentencesResources
    Cell viability assays: Vero E6 cells were seeded in 96-well plates, and 24 hours later, when 80% confluence was reached, Argovit was added to the medium at serial two-fold dilutions, in triplicates.
    Vero E6
    suggested: RRID:CVCL_XD71)
    Software and Algorithms
    SentencesResources
    IC50 values were calculated using GraphPad software (Prism).
    GraphPad
    suggested: (GraphPad Prism, RRID:SCR_002798)
    Data analysis: Data analysis was performed through the SPSS statistical program (version 26).
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Taking this limitation into account we could observe a clear dose-dependent inhibitory effect over SARS-CoV-2 infectivity. To our knowledge, this study is the first experimental trial where AgNPs are applied as a mouthwash and nose rinse solution for the prevention of SARS-CoV-2 infection in health care personnel working with COVID-19 diagnosed patients. The study was carried out in a prospective, controlled and randomized way for 9 weeks in the period of pandemic by COVID-19 from April to June 2020 in Tijuana Baja California, Mexico. The characterization of the two groups showed no significant statistical differences in gender, occupation and comorbidities related to the complication of SARS-CoV-2 infection. However, a statistically significant difference was identified in variables such as: age (p = 0.004), average age 35 in the experimental group and average age 33 in the control group; anti-influenza vaccination (p = 0.000), (66%) in the experimental group and (86%) in the control group, even though, vaccination against influenza virus reduces morbidity/mortality among medical personnel exclusively against influenza virus, but does not have any antigenic similarity with SARS-CoV-2 virus, as an example in this study, the control group reported a higher percentage of participants vaccinated against influenza and a higher percentage of infection by SARS-Cov2; Body Mass Index (p = 0.000), (25.95) in the experimental group and (28.93) in the control group, both groups classify...

    Results from TrialIdentifier: We found the following clinical trial numbers in your paper:

    IdentifierStatusTitle
    NCT04894409CompletedEvaluation of Silver Nanoparticles for the Prevention of COV…

    Results from Barzooka: We found bar graphs of continuous data. We recommend replacing bar graphs with more informative graphics, as many different datasets can lead to the same bar graph. The actual data may suggest different conclusions from the summary statistics. For more information, please see Weissgerber et al (2015).

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

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  3. Version published to 10.1101/2021.05.20.21256197v1 on medRxiv