Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative organism that is highly contagious and has been responsible for more than 240 million cases and 5 million deaths worldwide. Using masks, soap-based hand washing, and maintaining social distancing are some of the common methods to prevent the spread of the virus. In the absence of any preventive medications, from the outset of pandemic, alcohol-based hand sanitizers (ABHS) have been one of the first-line measures to control transmission of Coronavirus Disease 2019 (COVID-19). The purpose of this narrative review is to evaluate the sensitivity of SARS-CoV-2 towards ABHS and understand their potential adverse effects on humans. Ethanol and isopropanol have been the most commonly used alcohols in ABHS (e.g., gel, solution, spray, wipes, or foam) with alcohol in the range of 70–85% v/v in World Health Organization or Food and Drug Administration-approved ABHS. The denaturation of proteins around the envelope of SARS-CoV-2 positive sense single-stranded RNA virus is the major mechanism of action of ABHS. Due to frequent use of high-percentage alcohol-containing ABHS over an extended period of time, the oral, dermal, or pulmonary absorption is a possibility. In addition to the systemic toxicity, topical adverse effects such as contact dermatitis and atopic dermatitis are plausible and have been reported during COVID-19. ABHS appear to be effective in controlling the transmission of SARS-CoV-2 with the concern of oral, dermal, or pulmonary absorption.
Highlights
Coronavirus Disease 2019 (COVID-19), which was first reported from Wuhan, China in December 2019, has inflicted major public health and economic disasters throughout the world
A recent report demonstrated that furin-cleavage site is associated with a diminished stability of SARS-CoV-2 S protein, and it enables the virus to assume a conformational adaption that is critical for the binding of the S protein to the Angiotensin Converting Enzyme 2 (ACE2) receptor [31]
This principle has been exploited by alcohol-based hand sanitizers (ABHS) to denature the proteins surrounding the envelope which eventually blocks the capsid to attach to the host
Summary
Coronavirus Disease 2019 (COVID-19), which was first reported from Wuhan, China in December 2019, has inflicted major public health and economic disasters throughout the world. Prevention strategies recommended by the health agencies such as WHO and Centers for Disease Control and Prevention (CDC) early in the pandemic have been highly useful. These measures included social distancing, use of masks, and frequent application of ABHS [1,10]. Despite virucidal property of ABHS towards SARS-CoV-2, the active ingredient alcohols, such as ethanol, isopropanol, in ABHS may pose toxicity to both human health and environment. These toxicities potentially occur through dermal absorption, inhalation, and ingestion following recurrent use. The dual effects of ABHS in fighting COVID-19 transmission and potential exposure of humans to alcohol-related toxicities will be appreciated through this study
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
