Can using a neti pot help prevent SARS-CoV-2 infection?

Staying Safe Treatments

A: Possibly. There is no specific evidence for COVID-19 yet, but use of a neti pot *may* provide a benefit with limited risks. But don’t use it as a replacement for any other preventive measures.

Neti pots are a type of “nasal irrigation” that are used to help clear sinuses and treat symptoms of allergies, sinus problems, or colds. While the exact mechanisms are not known, nasal irrigation is hypothesized to improve symptoms through removal of mucus and inflammatory mediators from the nose. Limited research suggests that the chloride in salt may inhibit viral replication.
Scientific evidence generally supports the efficacy of nasal irrigation for chronic sinus problems, but less research has been done on prevention of acute infections. Those studies that do exist are small and focused on symptoms rather than transmission.

In a study of 401 children aged 6-10 with cold/flu symptoms randomly assigned to nasal irrigation, kids who received nasal irrigation showed significant improvement in sore throat, cough, nasal obstruction and secretion and less use of medication. Children in the nasal irrigation group also reported significantly fewer illness days, school absences and complications.

A small randomized study from 2011 found that among those presenting with upper respiratory tract infections, patients assigned to nasal irrigation 3 times a day had reduced severity and shortened duration of illness.

In another small randomized study from 2019 of people infected with a variety of common cold viruses (including coronaviruses), nasal irrigation reduced viral shedding, the duration of illness, over the counter medicine use and illness in household members. The authors argue that nasal irrigation may inhibit viral replication and thus transmission.

In light of COVID-19, the authors of this study conducted additional analysis focused on the subset of coronavirus infections and called for consideration of nasal irrigation as a COVID-19 treatment option.

BOTTOM LINE: The evidence base for nasal irrigation and infection prevention is small and suggestive rather than conclusive. The evidence for alleviation of symptoms, especially for chronic sinusitis, is stronger.

We do know that SARS-CoV-2 initially replicates in the nose, so prevention targeting this site is not unfounded.

Nasal irrigation has been shown to be generally safe and effective with minimal side effects. So if this is something you are doing or have been meaning to try, it won’t hurt and *may* provide some protection against transmission or severity of respiratory infections including SARS-CoV-2.

If you do try a neti pot, remember these hygiene rules:
1) Don’t use tap water (Use distilled, filtered, bottled or boiled water at room temperature)
2) Rinse the irrigation device after each use with hot water and soap and leave the device open to air dry completely.
3) Especially during a pandemic, DON’T SHARE YOUR NETI POT!

And when you are not irrigating…don’t forget to COVER YOUR NOSE with that mask!

The Nerdy Girls
Academic overviews of nasal irrigation:

Link to original FB post