Simple Solutions to Complex Problems: Gargling Salt Water Significantly Cuts COVID-19 Hospitalization Risk
Rinsing your throat or nose with a salt water (saline) solution may help protect against severe COVID-19 infection, based on a new study presented this week at the annual meeting of the American College of Allergy, Asthma and Immunology (ACAAI) in Anaheim, California. The research found that the risk of hospitalization for people with the virus who regularly gargled with salt water or used it as a nasal rinse (as with a neti pot) was significantly lower than for individuals in a reference group who did not follow a saline regimen.
“The rate of hospitalization was much more in our reference population who did not use a salt rinse,” says study coauthor Jimmy Espinoza, MD, in the department of obstetrics, gynecology, and reproductive sciences at UTHealth’s McGovern Medical School in Houston. “The findings indicate a possible association between a saline regimen and improved respiratory symptoms from coronavirus infection. Future studies are needed to see if our results can be replicated.”
Previous analysis has suggested that gargling or flushing nasal passages with salt water may promote a shedding of the virus and infected cells or possibly cause some inactivation of the infection. Dr. Espinoza emphasizes, however, that a saline rinse is no substitute for vaccination or antiviral treatments, which are proven to be very effective.
“Vaccination is so important because it definitely lowers the risk of hospitalization, and we don’t pretend that this saline rinse is better than conventional antiviral medications. We think that this intervention might be helpful in improving symptoms in some people.”
Espinoza, who is fully vaccinated, believes gargling with salt water helped alleviate some of his symptoms when he became infected with the coronavirus. “This is just an anecdote, but I felt that gargling helped relieve my congestion and ability to breathe, which in turn improved my sleep.”
Gargling Salt Reduced Hospitalization Rates for People With COVID-19
For the research, 58 individuals between ages 18 and 65 who tested positive for COVID-19 between 2020 and 2022 were selected to undergo either a low- or a high-dose saline regimen for five minutes, four times a day, over the course of 14 days.
The low dose was about 1/3 teaspoon of salt dissolved in 8 ounces of warm water, while the high dose measured 1 teaspoon of salt. The scientists excluded anyone with chronic high blood pressure because they didn’t want to expose them to any additional salt absorption, which could further raise their blood pressure. They then compared hospitalization rates of those in the treatment group with outcomes of about 9,400 people with positive SARS-CoV-2 infection who did not follow a salt rinse routine.
The hospitalization rates were 18.5 percent in the low-dose saline group and 21.4 percent in the high-dose saline group. Those numbers were significantly lower compared with the reference population, whose hospitalizations rate was nearly 60 percent.
That hospitalization rate here is very high compared with other available data. The global research firm Gallup has previously calculated the hospitalization rate for the vaccinated population to be 0.01 percent (or 1 in 10,914) and 0.89 percent (or 1 case in 112 people) for unvaccinated adults.
Espinoza noted that data was insufficient to explain why the hospital rate was so high in this study, but speculated that chronic illness and lack of vaccination may have been contributing factors that predisposed many participants to more serious sickness.
He added that when it came to vaccination, the rate was 10 percent in the control group versus about 11 percent in the low-salt group and nearly 18 percent in the high-salt group.
Salt Water Gargling May Offer Symptom Relief, But Is No Replacement for Vaccination
Researchers observed that duration of symptoms was similar between the two salt groups, at up to six to seven days. Details on symptom duration were unavailable for the reference group, so no comparison could be made for that factor.
“Previous studies, however, seem to show that gargling with salt water or other solutions has some relative impact on reducing duration of symptoms and viral load,” says Niraj Patel, MD, a pediatric allergy and immunology specialist with Duke Health in Durham, North Carolina.
Dr. Patel, who was not involved in the study but is a member of the American College of Allergy, Asthma, and Immunology, also emphasized that gargling with salt water is no substitute for vaccination.
“Vaccination is still the No. 1 way to prevent hospitalizations and severe infection,” he says.
As to why salt water may have this beneficial effect, the answer is still uncertain. Patel would like to see further research that explores how salt water may be inhibiting the replication of the virus.
He also pointed out that this study was limited in that it didn’t detail much about participant health factors such as obesity, COPD, and other chronic illnesses that could have influenced results.
“I advise talking to your doctor before instituting regimens like these, particularly if you have chronic diseases,” says Patel.
Until Next time: Stay Safe, Stay Healthy and be Careful out in the World.
James A Vito, D.M.D