Best Disinfectants for COVID-19 A Systematic Review on Surface and Skin Sanitizers

Introduction

Key Findings on Hand Sanitizers

This systematic review analyzed over 34 studies to evaluate the virucidal activity of various hand sanitizers against SARS-CoV-2 and similar viruses:

  • 85% Ethanol: Found to be one of the most effective formulations, showing a 5.5 log₁₀ reduction of SARS-CoV in 30 seconds. It’s also endorsed by the WHO for pandemic scenarios.
  • Ethanol Combinations:
    • Ethanol (78%) + Povidone-Iodine (3.2%) → Strong virucidal action against enveloped viruses.
    • Ethanol + Citric Acid + Urea → Broad-spectrum efficiency even at lower exposure times.
  • Povidone-Iodine (PVP-I) 7.5%: Demonstrated excellent results against enveloped viruses within just 15 seconds.
  • Chlorhexidine: Effective primarily against bacteria but limited against viruses.
  • Soaps and Surgical Scrubs: Particularly those containing potassium oleate and sodium laureth sulfate showed significant viral load reduction by disrupting lipid membranes.

Efficacy of Surface Disinfectants

Surface contamination is a major transmission vector. This review highlights the top-performing surface disinfectants:

  • 0.5% Sodium Hypochlorite: Highly effective against murine hepatitis virus (SARS surrogate), with virucidal action in under 30 seconds.
  • Accelerated Hydrogen Peroxide (0.5%): Rapid action within 1 minute, useful in automatic disinfectant tunnel systems.
  • Phenolic Solutions (0.5%–2%): Effective against a broad spectrum, including HIV and HBV, particularly when visible organic matter is minimal.
  • Glutaraldehyde + QAC + Isopropanol Mix: Superior performance with >3 log₁₀ reduction in viral titers for both enveloped and non-enveloped viruses.

Broader Implications for Public Hygiene

The implications of this review reach beyond hospitals. The American Food Safety Authority and the FDA emphasize the need for:

  • High-temperature laundry cycles (≥71°C) or cold washes with bleach for clothing sanitation.
  • UV-C light disinfection in healthcare and public facilities like gyms and elevators.
  • Regular cleaning of frequently touched surfaces, such as elevator buttons and gym equipment, with appropriate virucidal agents.

Practical Applications for Everyday Settings

  • Hand hygiene remains the first line of defense: 85% ethanol or PVP-I scrub recommended.
  • Food and Kitchen Safety: Avoid soap on produceuse running water and clean utensils.
  • Public Area Sanitization: Use diluted bleach (1:99) for lift buttons, gyms, and shared areas.
  • Mask and PPE Disinfection: Employ UV or hydrogen peroxide vapor treatments as per updated health protocols.

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