Photo: Koldunov (Shutterstock)
In a recent study, twice daily nasal irrigation was found to reduce the severity of COVID-19 symptoms. Although the study in question had some pretty major flaws—including a small sample size and the lack of a proper control group—the researchers “are probably on the right track,” said Mas Takashima, an ENT specialist at Houston Methodist Hospital, who was not associated with the study. “Nasal irrigation is something we commonly recommend for our patients who have any kind of infection of the nose or sinuses.”
This includes colds, flus, and allergies, for which there is a certain amount of evidence that nasal irrigation can be an effective way to reduce the severity of symptoms. By that logic, it makes sense that nasal irrigation can be a strategy for reducing the severity of COVID-19 symptoms.
Nasal irrigation can be useful for upper respiratory infections
Nasal irrigation works by using a saline solution to flush out the sinuses. This flushing has a two-fold benefit: It gets rid of all the mucus, which will help you feel better, while also getting rid of any viruses or bacteria that are in there. Since a lot of the viruses that cause upper respiratory tract infections, which includes COVID-19, tend to proliferate in the sinuses, getting rid of them through nasal irrigation can help cut down on the overall viral load, which is known to help with symptom severity.
“Because the SARS-CoV-2 virus replicates in the nose, and keeps replicating in the nose, theoretically, it should work,” said Catherine Troisi, an epidemiologist at UTHealth School of Public Health who was not associated with the study.
Flushing out the mucus also has the added benefit of reducing any potential secondary infections, as mucus provides an ideal environment for bacteria to grow in. “If you have an open sinus that is constantly circulating, it doesn’t get infected as often as something that is blocked off,” Takashima said.
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Tips for effective nasal irrigation
In the COVID-19 study, researchers had participants perform nasal irrigation with either a sodium bicarbonate solution or a saline solution with iodine added in, using a pressurized nasal irrigation system, where you squirt the solution into the nostrils. Researchers found no difference between the two in terms of outcomes, with the major limitation being that it was a very small sample size of 79 total participants.
Practically speaking, it’s a reasonable assumption that most people will find benefit from using a simple saline solution, which they can either buy premixed in small packets, or make themselves using a mixture of salt and baking soda. This is the standard solution that can help with allergies, colds, and flus.
For a nasal irrigation system, the options are to either use a neti pot, where you pour the solution into one nostril, or a nasal irrigation bottle, where you squirt the solution into one nostril. Both of these should be available at your local drugstore or can be ordered online.
It’s important to use clean water, preferably either distilled or boiled, as you don’t want there to be any harmful bacteria in there, but you want to avoid using plain water. “It hurts when there is no salt in there,” Takashima said. To prevent contamination, be sure to wash the bottle after every use, and change it every few months, or after an illness. “If you have an active sinus infection, you’ll want to get rid of that bottle,” once you’ve recovered, Takashima said, as there can still be lingering bacteria or virus.
There is also a learning curve associated with nasal irrigation. “It does feel funny at first,” Troisi said. To get the hang of things, it can help to watch Youtube videos on proper technique, and to go slowly in the beginning. In terms of frequency, Takashima advises adjusting for comfort, which can mean a couple times a week for people with mild allergies or a couple times a day during an illness.
