In a phase 2 randomized, double-blind trial involving 450 healthy adults, azelastine 0.1% nasal spray demonstrated a significant reduction in polymerase chain reaction-confirmed SARS-CoV-2 infections over 56 days, with infection rates of 2% versus 7% in the placebo group. Participants used one puff per nostril three times daily, with symptomatic COVID-19 cases at 2% for azelastine versus 6% for placebo. Adverse events were similar, though azelastine was linked to increased bitter taste and nosebleeds. The study suggests potential antiviral mechanisms, but limitations such as a highly vaccinated cohort and the single-center design were noted.

Source: JAMA Internal Medicine