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A phase 2 clinical trial found that azelastine nasal spray could potentially prevent COVID-19 infections in healthy adults, as published in JAMA Internal Medicine. Among 450 study participants, SARS-CoV-2 infection as determined by polymerase chain reaction testing occurred in 2.2% of those using azelastine compared with 6.7% in the placebo group, representing a 67% relative risk reduction (odds ratio, 0.31; 95% confidence interval, 0.11-0.87). Symptomatic COVID-19 infections were also less frequent with azelastine (1.8% vs 6.3%). Infected participants on azelastine developed illness later and had shorter durations of positivity (3.4 days of positivity vs 5.1 days). The spray also reduced rhinovirus infections, which were found in 1.8% of the azelastine group vs 6.3% in the placebo group. The 227 subjects in the treatment group used a 0.1% azelastine nasal spray 3 times per day over a 56-day period, and the 223 subjects in the control group used a placebo spray 3 times a day. Researchers suggest azelastine may be an option for COVID-19 prevention, but the findings warrant additional study.
Easy access: What’s encouraging about the study is that targeting nasal mucosa could be a relatively simple way to reduce COVID infection even as the virus mutates—not to mention that azelastine is a common over-the-counter product easily accessible for most consumers.