Saline nasal drops shortened colds in young children, reduced household transmission

Key takeaways:

• Parents administered saline nose drops a median of three times per day for a median of 5 days.
• Fewer household members developed cold symptoms in the nasal drop group (41% vs. 58%).

Hypertonic saline nose drops shortened cold symptom duration in young children and decreased household transmission, according to findings presented at the European Respiratory Society International Congress in Vienna.

The ELVIS-Kids study was inspired by the use of saltwater solutions in South Asia to treat cold symptoms, according to a press release.

“Hypertonic saline can reduce symptom duration in children aged 0 to 6 years by 2 days (a 25% relative reduction) and can also reduce transmission of colds within households and reduce the need for families to buy pharmacy medicines as treatments,” Steve Cunningham, MBChB, PhD, professor of pediatric respiratory medicine in the department of Child Life and Health at The University of Edinburgh, told Healio.

The randomized controlled trial included 301 children aged 0 to 6 years with upper respiratory tract infections. The researchers assigned 150 children to receive hypertonic saline nose drops (2.6%) and 151 to receive typical cold care.

In the nose drops group, they taught parents how to make 2.6% saline with sea salt and water and instructed parents to administer three drops in each nostril four times per day. Parents in both groups documented symptoms and side effects for 28 days following symptom onset. The researchers also swabbed children’s noses for the first 5 days of symptoms to test for viruses.

Parents reported administering the saltwater drops a median of three times per day for a median of 5 days. The children who received nose drops experienced a median of 6 days of symptoms (interquartile range [IQR], 5-9 days), whereas the control group experienced a median of 8 days of symptoms (IQR, 5-11 days; P = .004).

“We anticipated that this would be for all children with a cold, but the difference was only observed in children where a virus was detected,” Cunningham said. “There was also a small but significant effect on how frequently wheeze was reported in children during a rhinovirus common cold infection.”

Fewer household members developed cold symptoms in the nose drops group than the control group (41% vs. 58%; P = 0.008).

In the press release, Cunningham explained that the mechanism of action: “Salt is made up of sodium and chloride. Chloride is used by the cells lining the nose and windpipes to produce hypochlorous acid within cells, which they use to defend against virus infection. By giving extra chloride to the lining cells this helps the cells produce more hypochlorous acid, which helps suppress viral replication, reducing the length of the virus infection, and therefore the duration of symptoms.”

The researchers reported mild and infrequent side effects of hypertonic saline during the study, including sneezing, runny nose and pain. No serious adverse events were reported.

“There are no licensed premade hypertonic saline nose drops available for children,” Cunningham told Healio. “There are premade saline nose drops available from pharmacies, these are not the strength that was used in the trial and so may not be as effective. We hope that a hypertonic saline nose drop product that could be used to treat children will be developed soon.”

References:

• Ramalingam S, et al. Abstract OA1985: A randomized controlled trial of hypertonic saline nose drops as a treatment in children with the common cold (ELVIS-Kids trial). Presented at: European Respiratory Society International Congress; Sept 7-11, 2024; Vienna.
• Saline nasal drops reduce the duration of the common cold in young children by two days. https://www.eurekalert.org/news-releases/1056546?. Published Sept. 5, 2024. Accessed Sept. 5, 2024.
• How to make and apply salt water nose drops. https://www.elviskids.co.uk/salt-water-nose-drops.html. Accessed Sept. 5, 2024.