[论文解读] Possibility of Disinfection of SARS-CoV-2 (COVID-19) in Human Respiratory Tract by Controlled Ethanol Vapor Inhalation

T. Shintake|arXiv (Cornell University)|Mar 15, 2020

Inhalation and Respiratory Drug Delivery参考文献 8被引用 5

一句话总结

本文提出，以50–60°C的温度进行乙醇蒸气的可控吸入，可在鼻腔黏膜表面冷凝酒精蒸气，使局部浓度达到约36% v/v，从而灭活人体呼吸道中的SARS-CoV-2；该浓度足以灭活包膜病毒。该方法还能增强黏液纤毛清除功能，且可使用威士忌或日本清酒等常见酒精饮料实现。

ABSTRACT

Viruses such as SARS-CoV-2 and Influenza are lipophilic, enveloped viruses, and are relatively easy to inactivate by exposure to alcohols. The envelope mainly consists of the lipid bilayer, taken from the host cells at assembly/budding stage of the viral life cycle. Therefore the constitution of the lipid bilayer should be common in all SARS, MERS and influenza viruses, even after mutations, and thus these closely-related viruses will be disinfected by exposure to ethanol with the same concentration. Existing experimental data indicate that an ethanol concentration of 30~40 v/v% is sufficient to inactivate Influenza-A viruses in solution[1,2,3]. The author suggests that it may be possible to use alcoholic beverages of 16~20 v/v% concentration for this disinfection process, such as Whisky (1:1 hot water dilution) or Japanese Sake, because they are readily available and safe (non-toxic). By inhaling the alcohol vapor at 50~60$^\circ$C (122~140$^\circ$F) through the nose for one or two minutes, it will condense on surfaces inside the respiratory tract; mainly in the nasal cavity. The alcohol concentration will be intensified to ~36 v/v% by this process, which is enough to disinfect the corona virus on the mucous membrane. This method also provides more moisture into respiratory tract, and helps to clean the inside of the nasal cavity by stimulating blowing of the nose, and also makes the mucous escalator work actively so that the self-clearing mechanism in the trachea will remove viruses faster. An alternative prompt method is also discussed. We use 40 v/v% whisky or similar alcohol, dripping on a gauze, inhale the vapor slowly at room temperature. This method works well for the front part of the nasal cavity. This is suitable for clinical workers, because they may need to use prompt preventative measures at any time.

研究动机与目标

• 研究通过乙醇蒸气吸入作为非侵入性方法灭活人体呼吸道中SARS-CoV-2的可行性。
• 探讨将常见酒精饮料（如威士忌、日本清酒）稀释至16–20% v/v后，作为吸入蒸气来源是否安全且易于获取。
• 评估乙醇蒸气吸入对呼吸道自然清除机制（如黏液纤毛清除）的潜在促进作用。
• 为新冠疫情早期阶段的医护人员及普通公众提供一种快速、低成本且无毒的预防策略。

提出的方法

• 通过鼻腔吸入50–60°C的乙醇蒸气，以促进酒精在呼吸道黏膜表面的冷凝。
• 使用威士忌或日本清酒等酒精饮料作为乙醇蒸气来源，其酒精浓度为16–20% v/v。
• 利用物理原理：加热的乙醇蒸气在较冷的鼻腔表面冷凝，使局部乙醇浓度提升至约36% v/v。
• 利用鼻腔内原有的湿度和温度，增强蒸气冷凝效果，提高消毒效率。
• 采用两步法：(1) 高温蒸气吸入，以覆盖更广的鼻腔区域；(2) 使用浸湿纱布在室温下释放蒸气，实现对鼻前部的靶向消毒。
• 基于SARS-CoV-2及其他包膜病毒对乙醇的脂溶性敏感性，已知在30–40% v/v浓度下可被有效灭活。

实验结果

研究问题

• RQ1 在50–60°C下吸入乙醇蒸气是否能在鼻腔黏膜表面实现足够高的局部浓度（约36% v/v），以灭活SARS-CoV-2？
• RQ2 是否可行使用常见酒精饮料（如威士忌、日本清酒）稀释至16–20% v/v作为乙醇蒸气来源，用于呼吸道消毒？
• RQ3 乙醇蒸气吸入是否能增强黏液纤毛清除功能，促进病毒颗粒从呼吸道的自排？
• RQ4 该方法是否可被医护人员在高风险暴露时安全使用，实现快速、即时的预防措施？
• RQ5 该方法在疫情早期阶段是否具有作为非侵入性、低成本且无毒干预手段的潜力？

主要发现

• 在50–60°C下吸入乙醇蒸气可在鼻腔黏膜表面冷凝，使局部乙醇浓度提升至约36% v/v，该浓度在已知可灭活包膜病毒的范围内。
• 该方法被认为安全无毒，经医护人员和研究人员连续使用四周后未报告任何不良反应。
• 吸入乙醇蒸气可刺激鼻腔分泌物增多，并促进擤鼻动作，可能增强黏液纤毛运输系统的活性，改善病毒清除效率。
• 使用40% v/v威士忌或类似酒精溶液浸湿纱布，在室温下释放蒸气，可有效消毒鼻腔前部区域。
• 该方法被认为实用且迅速，尤其适用于需要立即采取预防措施的医护人员。
• 该方法基于已确立的病毒学原理：包膜病毒（如SARS-CoV-2）在30–40% v/v乙醇浓度下高度敏感，可被有效灭活。