Dr Alemka Markotic: Coronavirus Dislikes Salt Water, Clean Nose Regularly

Lauren Simmonds

Sometimes the big solutions are in the little things. Dr Alemka Markotic, the director of Zagreb’s Fran Mihaljevic Clinic for Infectious Diseases is also trying to check whether this is the case with the new virus that saw the world grind to a halt through a new study.

As Poslovni Dnevnik writes on the 20th of September, 2020, while the world’s pharmaceutical companies and the most prestigious scientists are busy working on the production of vaccines against the new coronavirus, Dr Alemka Markotic has stated that even some simple procedures such as maintaining good nasal hygiene can help fight respiratory infections in general.

The observations she cites are still in their initial controlled study phases, but this finding cannot certainly be harmful to anyone. The idea for the study, she explained, was born out of trying to help asymptomatic infected people who had been in isolation for weeks because of a positive swab test that was no longer in line with their state of health because they were feeling well. The key is in saline solutions that the new coronavirus, much like other viruses, finds hostile.

”From the very beginning of the pandemic caused by SARS-CoV-2, scientists and doctors have noticed that in a number of patients, but also in people who have been diagnosed with the infection but haven’t developed symptoms, we can detect the virus in the nasal mucosa for a long time. Cases of over two months of positive swabs have been reported in some individuals. In the first few months of the pandemic, while we didn’t know how long the virus could be infectious for, it was associated with the long-term stay of positive people in isolation, which led to certain psychological problems, but also existential ones due to long-term isolation and the inability to return to work,” said Dr Alemka Markotic in conversation with 24sata. She is exploring the possibility that in a number of people, slowing down or preventing the spread of the virus from the nose to the lungs could be done with the simple use of saline.

”During the spring and early summer, some people with long-term positive swabs turned to me for help. Since there’s no specific cure for now, I was thinking how best I might help them. The assumption was that the results of the swabs were probably made up of defective virus particles or viruses that had lost their power to infect, but there wasn’t enough information in the relevant scientific and professional literature to attest to it for sure and they had to be isolated until negative results were obtained from them. I thought that maybe a good nasal clean, that is, rinsing and moisturising the nose with sea salt-based preparations, could help remove the dead epithelium in the nose, and thus the viral particles from that epithelium.

I advised people to refresh and clean their noses 3-4 times a day by injecting seawater-based preparations for 2-3 days and then do another control swab. In most cases, after that procedure, the test returned negative and they could finally leave isolation and return to their “new normal” lives,” explained Dr Alemka Markotic. The next step was to scientifically prove this interesting observation.

”As these were individual observations and experiences, which definitely need confirmation in a controlled study in order to be considered scientifically and professionally relevant and applicable, we launched a pilot study at the Clinic for Infectious Diseases in Zagreb. In the study, we’ll try to examine patients with COVID-19 and see how much regular nasal bathing with seawater-based solutions can reduce the presence of the virus in the nose, and if the results are encouraging, we plan to continue the study in asymptomatic cases to reduce the possible spread of the virus to the lower parts of the respiratory system, ie towards the lungs,” she noted.

She stressed that maintaining a healthy nasal mucosa is extremely important in general.

“Doctors regularly give such advice to their patients, and it’s good that now, before the season of respiratory infections comes around, where the flu will play a big role, we remind everyone of this type of protection. The nasal mucosa is the site of entry of numerous microorganisms that cause respiratory tract infections. Cells that line a healthy and undamaged mucosa represent a physical barrier to the entry of microorganisms and the contraction of disease. The nasal mucosa provides heating, moisturising and purification of the inhaled air.

In addition, IgA antibodies are secreted on the surface of the mucosa that can offer local protection against various microorganisms. Cold weather, but also overheated areas with dry air damage the mucous membrane, cause inflammation and swelling of the mucous membrane and increase the possibility of microorganisms settling on it. Therefore, keeping the mucosa moist and undamaged, including regular nasal cleaning, is important in defense against microorganisms,” said Dr Alemka Markotic.

To ensure nasal patency and normal breathing, Markotic added, various drops are used to reduce mucosal swelling, but most such drops should only be applied for a short time, as their long-term use can also lead to damage to the nasal mucosa.

“For the daily moistening of the nasal mucosa and the prevention of damage to the mucosa, seawater-based solutions are recommended. Salt reduces swelling by binding water from the mucosa, dilutes the mucus and facilitates its expulsion, and can also have an anti-allergic effect. It can also physically remove dead and damaged nasal epithelial cells.

In the current era of COVID-19, in addition to measures of distance, hand hygiene and wearing masks, it’s important to maintain proper nasal hygiene, which includes regular cleaning and moisturising, especially since the prolonged wearing of masks can further reduce the normal wetting of the nasal mucosa,” concluded Dr Alemka Markotic for 24sata.

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