SARS-CoV-2 coronavirus enters into the human body mainly through the angiotensin converting enzyme 2 (ACE2) and transmembrane protease serine 2 (TMPRSS2) nasal epithelial cells. Like many other airborne viral diseases, penetration into the upper respiratory tract (URT) is the first step of the infection. Once SARS-CoV-2 enters the host via the respiratory tract, airway and alveolar epithelial cells, vascular endothelial cells and alveolar macrophages are among the first targets of viral entry. Several studies have reported that the viral loads in the upper respiratory tract (URT) peak at the time of, or early after, onset of symptoms. Higher virus load in upper respiratory tract (URT) also induces a higher overall SARS-CoV-2 household secondary attack rate.~Nasal saline irrigations are frequently prescribed for both prevention and treatment of upper respiratory tract infections (URTIs). Nasal wash provides mechanical cleansing of mucus, crust, cell debris and various air contaminants including pathogens (virus and bacteria). It enhances mucociliary clearance and reduces the mucus contact time of airborne elements. The effectiveness of nasal lavage has been shown to reduce the duration of infectious episodes and relieve symptoms of upper respiratory tract infections (URTIs) caused by various respiratory viruses including coronaviruses. Preliminary data showed that daily nasal wash can significantly reduce symptom duration in subjects with mild and moderate forms of COVID-19.~The sponsor hypothesized that the daily use of seawater nasal wash in subjects with mild to moderate forms of COVID-19:~Would relieve nasal symptoms caused by SARS-CoV-2 virus, including nasal obstruction and rhinorrhea.~Would reduce the intranasal viral load by mechanical evacuation of nasal secretions containing the SARS-CoV-2 virus, and by reducing the contact time between the SARS-COV-2 virus and the nasal mucosa.~The main objective of this study is to evaluate the effectiveness of Physiomer®, an undiluted isotonic seawater nasal spray, on reducing the duration of nasal symptoms of COVID-19 (nasal obstruction or rhinorrhea) in subjects with mild to moderate COVID-19.~The study will take place in France among adults subjects with mild to moderate COVID-19 who developed nasal obstruction and rhinorrhea no more than 48 hours before study inclusion. Subjects positive for SARS-CoV-2 will be randomized into one of two study groups: control group or nasal wash group. Subjects in the nasal wash group will be asked to perform daily nasal wash for a 3 weeks period with Physiomer®, a 100% seawater isotonic nasal spray. Subjects in both groups will complete daily online questionnaires for a 3 weeks period. In order to follow the evolution of nasal SARS-CoV-2 viral load, 4 naso-pharyngeal swabs will be collected at home by a nurse.
Randomized, controlled, multicenter, parallel group trial to assess the efficacy of Physiomer®, a natural seawater nasal spray, to reduce duration of COVID-19 nasal symptoms and reduce SARS-CoV-2 viral load in subjects with mild to moderate COVID-19 disease.