Abstract Rationale The nasal mucosa is a primary site of exposure and replication for respiratory pathogens, yet current measures only partially mitigate airborne transmission. Healthcare workers (HCW) remain at heightened risk of infection. We evaluated the feasibility, safety, and acceptability of a novel Pathogen Capture and Neutralizing Spray (PCANS), commercialised as Profi Nasal Spray for nasal hygiene among HCW. PCANS, formulated by inactive excipients, acts by three key steps- enhance the capture of pathogen-laden respiratory droplets from inspired air, form a physical barrier over nasal mucosa to intercept invasion/colonization of different pathogens and rapidly neutralize a wide range of pathogens. Methods Eligible HCW were randomized 1:1 to intervention or control. The intervention group participants used the spray twice daily. All participants completed online surveys every 3 days for 8 weeks. Those who reported respiratory symptoms completed the Respiratory Infection Intensity and Impact Questionnaire for symptomatic days. Primary outcomes included feasibility (willingness to participate), acceptability (adherence based on assessment of bottle weight and dropout rates) and safety. Compliance with nasal spray use was assessed by bottle weight: participants whose bottles retained ≤20% of the expected remaining volume at 8 weeks were considered fully compliant, and those with ≤50% were considered at least 50% compliant. Statistical analyses were performed using Fisher’s Exact Test, Wilcoxon signed-rank test, in R(version 4.5.0). Results Of 136 enrolled participants,9 dropped out after enrolment and 9 from intervention arm were excluded for noncompliance (67 controls, 51 intervention). Among 60 intervention participants, 85% were compliant with daily use and 41% were fully compliant. Acceptability and ease of use was 100%. The spray was well tolerated; 29% reported mild, transient stinging, however all continued to use the spray. Among those exposed to a patient with Influenza/RSV/COVID-19, the intervention group showed 62% lower incidence of symptoms compared to exposed controls. The median upper and lower respiratory scores were similar in symptomatic in both groups with control scores clustered around 1 and intervention around 0.5, with longer symptom duration. The intervention group reported?fewer symptom episodes(median 1) compared with controls(median 2). Conclusion Our study demonstrated Profi was well-tolerated and safe. Efficacy was not an endpoint of this study; however, numerical trends suggested lower incidence and shorter duration of respiratory symptoms among users, particularly in those exposed to viral infections. These findings support the feasibility of PCANS (Profi) nasal spray technology as a prophylaxis strategy for HCW and warrant larger-scale studies. This abstract is funded by: Akita Biosciences
Khan et al. (Fri,) studied this question.