A Pathogen's Guide to the Nose (Review)

Part II: Therapeutics, Prophylaxis, and Vaccination

I previously indicated the vital role the nasal route plays in virus infection and how this could lead to the manifestation of anosmia and possibly other neurocognitive impairments. It would make sense then to argue that interventions administered intranasally may provide the best route of protection and treatment for the early stages of COVID, and that prophylactic measures may want to look in this direction if we want the best, full frontal response against the virus.

In this post I will outline intranasal treatment options, prophylaxis, and intranasal vaccinations, and argue the pros and cons of these interventions. Although there are many other routes, such as oral sprays, I have focused predominately on the nasal route (you’ll see that this post will already be far too long anyways!)

COVID Interventions

The early stages of COVID infection can be very difficult to gauge; some people may remain asymptomatic for most of their infection, some may have mild coughs while some will have flu-like symptoms a few days after exposure. Nonetheless, treatment options that can be administered intranasally during the mild or moderate symptoms may help to reduce viral load and provide greater benefits to viral clearance. Not only can therapeutics target the initial viral replication that occurs in the nasal passage, but nasal spray therapeutics can be directed towards the respiratory tract and the lungs. Providing a direct route to the lungs would be extremely important in the treatment of the disease, so targeting the nasal route can provide plenty of benefits in the fight against COVID.

Treatments for mild or moderate COVID disease will tend to focus on antiviral properties through the use of chemical compounds as well as antibodies, so I will outline a few of those compounds here. Also, because therapeutics and prophylaxis tend to overlap, I will list the compounds and note their therapeutic/prophylactic use, if applicable, together in order to reduce confusion.