Biomedical and Biotechnology Research Journal (BBRJ)

REVIEW ARTICLE
Year
: 2021  |  Volume : 5  |  Issue : 2  |  Page : 121--128

Disinfectants in the arena of COVID-19


Kamal Shah1, Sumit Chhabra1, Nagendra Singh Chauhan2,  
1 Department of Pharmaceutical Chemistry, Institute of Pharmaceutical Research, GLA University, Mathura, Uttar Pradesh, India
2 Senior Scientific Officer, Drugs Testing Laboratory Avam Anusandhan Kendra, Raipur (CG), India

Correspondence Address:
Dr. Kamal Shah
Institute of Pharmaceutical Research, GLA University, Mathura, Uttar Pradesh
India

Abstract

Currently, a disease name as corona (COVID-19) has become a serious problem around the globe. As of December 2020, the disease has spread to over 213 countries and territories around the world and 2 international conveyances, with over 79,850,900 confirmed cases and over 1,751,705 deaths. The ailment (COVID-19) is instigated by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). CoV impacts on the respiratory tract and causes infection that may be minor or deadly. Several studies reveal that coronavirus can remain live on nonliving surfaces (glass, metal, or plastic) for up to 9 days, but it may be denatured with many disinfectants having alcohol, benzalkonium chloride, sodium hypochlorite, etc., within 1 min. As we know, there is no fruitful therapy or medication for COVID-19 so early precaution and prevention is the only solution to break the chain of coronavirus. By using different types of disinfectants, we can inhibit the growth of this novel corona disease.



How to cite this article:
Shah K, Chhabra S, Chauhan NS. Disinfectants in the arena of COVID-19.Biomed Biotechnol Res J 2021;5:121-128


How to cite this URL:
Shah K, Chhabra S, Chauhan NS. Disinfectants in the arena of COVID-19. Biomed Biotechnol Res J [serial online] 2021 [cited 2021 Sep 16 ];5:121-128
Available from: https://www.bmbtrj.org/text.asp?2021/5/2/121/318423


Full Text



 Introduction



In the previous two decades, the third highly pathogenic human coronavirus is a novel coronavirus (2019). The transmission of the disease has been explained by one human to another both in clinic and society.[1],[2] It is very important to inhibit the transmission of the virus to the public and healthcare workers. The main cause of the spreading of coronaviruses is due to auto-inoculation of the mucosa of the mouth, nose, or eyes from infected dry surfaces.[3],[4],[5] Coronavirus can live on different metal surfaces from hours to days.[5] On plastic and stainless steel surfaces, this virus can live for about a weak which is explained by recent research. They also explained that this virus can remain in a live condition for a whole day on cardboard and for about 4 h only on a copper surface.[6] The microorganism can be denatured using different types of disinfectants on various surfaces. The aim of the review was, therefore, to summarize all available information regarding chemical components which are used in different types of sanitizers to sanitize the different types of infected surfaces and used against coronavirus. The chemical agents intended to inactivate or kill the microorganisms on inert surfaces are known as a disinfectant. Usually, disinfectants are categorized different from other antimicrobial agents such as antibiotics, which demolish microorganisms inside the body, and antiseptic, which demolish microorganisms on the skin. Biocides are also distinguished from disinfectants which are proposed to demolish all forms of living, not just microorganisms. Sanitizers are the preparations that concurrently clean and disinfect. Disinfectants are more effective in killing of microorganisms than sanitizers. Disinfectants are normally applied during the cleaning of hospitals, dental surgeries, kitchens, and bathrooms to destroy harmful organisms. Sanitizers are light in action compared to disinfectants and are basically applied on that belongings which are in human exposure whereas disinfectants are strong and are applied to clean surfaces like floors and building premises.[7] An outline of the different types of disinfectants is drawn in [Table 1]. For antimicrobial activity, many of them may be applied single or combination with other products.{Table 1}

 Alcohols



Even though a number of disinfectants in this category have been revealed to be useful against microbial contamination ethyl alcohol (ethanol and alcohol), n-propanol, and 2-propanol (sec-propyl alcohol, 2-hydroxypropane, dimethyl carbinol, propan-2-ol) are the most extensively applied.[8] Generally, isopropyl alcohol is more effective for bacterial treatment[9] and ethanol is more active in opposition to viruses. For example, the lipophilicity of isopropyl alcohol is greater than ethyl alcohol and due to this, isopropyl alcohol is less effective counter to water-loving viruses (e.g., poliovirus).[10] Normally, the effective concentration range of alcohol is between 60% and 90% to kill the microorganism. The correct mechanism of action of alcohols is not well recognized, but constructed on the improved efficiency in the occurrence of water; it is usually supposed that they result in membrane impairment and fast denaturation of proteins, with successive intervention with metabolism and breakdown of the cell.[8],[11]

 Aldehydes



Glutaraldehyde

Glutaric acid dialdehyde is applied as a disinfectant and sterilizing agent which is an important dialdehyde which is particularly used at lower temperature. It is utilized for disinfecting and sterilizing medical tools such as borescope, endoscopes, or as an adhesive in electron microscopy. Glutaric dialdehyde exhibits wide-ranging spectrum of action against microorganisms. It has action against bacteria, fungi, or viruses. The mode of action of glutaric dialdehyde has been published in earlier reviews.[12],[13],[14],[15]

Glutaraldehyde works on the bacterial cell by react on the cell surface and deprotonated amine on it.[16] It decreases the action of hepatitis B surface antigen and particularly hepatitis B core antigen (in hepatitis B virus [HBV]).[17] It binds with lysine remains on the surface of hepatitis A virus.[18]

Formaldehyde

The chemical name of formaldehyde is methanal (HCHO). It exists as gas at room temperature found to be freely soluble in water. The aqueous solution of formaldehyde (formalin) consists of 34%–38% (w/w) HCHO with methyl alcohol to reduce polymerization. It is clinically used at low temperature for the purpose of disinfection and sterilization. It is used as antimicrobial agent quite effective against bacteria, fungi, or viruses. Its efficiency is slower than glutaraldehyde.[15],[19]

It is not easy to explain the working of formaldehyde for microbial inactivation. Obviously, its interactive and cross-linking nature ought to participate in this action. Other examples of dialdehydes are oxaldehyde, butanedial, and o-phthalic dicarboxaldehyde; they kill spores formation. Of these, oxaldehyde and butanedial are feebly energetic. In glutaraldehyde, the space between the two aldehyde groups may be most favorable for the communication of these aldehyde groups in nucleic acids and specifically in amino acid linkage and enzymes present.[20]

o-Phthalaldehyde

OPA has effective bactericidal and sporicidal activity and is a novel kind of disinfectant which is recommended as a substitute for glutaric acid dialdehyde in endoscope disinfection.[21] o-Phthalaldehyde is having two aldehyde groups and aromatic in nature. The mode of action has been little known, but literature proposes that the mechanism is like glutaraldehyde.[22] Advance research is required to confirm this belief.

 Anilides



The anilides are mainly used as antiseptics and rarely as disinfectant in the health center. 3-(4-Chlorophenyl)-1-(3,4-dichlorophenyl) urea, i.e., triclocarban is majorly considered in the anilides and used in shampoos and deodorizers. The triclocarban is found to be less lively in Gram-negative bacteria and fungi as compared to Gram-positive bacteria.[23] The anilides are work by attacks on the cytoplasmic membrane. It binds to the cytoplasmic layer of the cell where it adsorbs and demolishes the membrane which causes destruction of the cell.[24]

 Biguanides



Chlorhexidine

1,6-bis (4-chloro-phenyl biguanido) hexane (chlorhexidine) is extensively used in antiseptic preparations, in handwash, and oral preparations as a disinfectant and preservative because of its wide-range activity. It is found to exert lesser exasperation to the skin and reported to be sage for use.[25]

Chlorhexidine is a bactericidal agent.[26] It works by damaging the outer cell layers,[27] although inadequate to provoke lysis or cell destruction. After that, apparently by passive diffusion, the cell wall or outer membrane is being crossed by the agent and consequently hits the microbial cytoplasmatic or inner layer or the plasma membrane of yeast.[28]

Chlorhexidine is not an efficient antiviral, and its action is limited to the lipid-enveloped viruses.[29] Ranganathan described about its action to be limited to the genetic material core or the outer layering.[30]

Alexidine

Alexidine is having ethylhexyl end groups which makes it differs chemically from chlorhexidine. Alexidine is more effective and produces more rapidly bactericidal activity.[31],[32] The chemical structure of alexidine made it special and differ it from chlorhexidine. It is made to generate the obstructions in the cellular membrane consist of lipid so that it cannot allow the microbes to grow.[32]

Polymeric biguanides

Polyhexamethylene biguanides (PHMB) have a large chain structure. They have molecular weight of about 3000. Polymeric biguanides can be used in the confectionery as well as in other food materials. It can be used in swimming pools as disinfectant.

Biguanides is used effectively in contrast to both types of bacteria, i.e., Gram-positive and negative, while Pseudomonas aeruginosa and Proteus vulgaris had mild susceptibility. Being a membrane-active drug, PHMB alters the reliability of the cellular outer membrane of Gram-negative bacteria, while the membrane works as a penetrability obstacle.[16],[33]

 Diamidines



The chemical classification of diamidines is discussed in [Table 1]. The literature supports that propamidine isethionate salts have potentially work as antimicrobial. Clinically, diamidines are used to treat surface ailments. It is still not known that how diamidines work, but if they are measured as cationic surface-active compounds. They can be expected to restrain oxygen uptake and provoke seepage of amino acids. Damage the cellular covering shell of P. aeruginosa and Enterobacter cloacae was explained.[34]

 Halogen-Releasing Agents



The most important halogens utilized in the hospitals and which are castoff for antimicrobial and disinfectant function are chlorine and iodine-based compounds.

Chlorine-releasing agents

There are many expert reviews available which explains the chemical, physical, and microbiological characteristics of chlorine-releasing agents (CRAs).[35],[36] The most significant CRAs such as sodium hypochlorite, chlorine (IV) oxide, and sodium troclosene. The disinfection of hard surfaces is widely done by sodium hypochlorite solutions (household bleach). The discharges of blood comprising human immunodeficiency virus or HBV can be disinfected by sodium hypochlorite solutions. Sodium and the hypochlorite ion are produced in water after ionization of sodium hypochlorite, which creates steadiness with hydrogen hypochlorite.[35]

The real action of CRAs is still unknown. CRAs are extremely lively oxidizing agents and thus demolish the cellular commotion of proteins.[35] The degree at which RNA gets inactivated in integral phage by chlorine is the same as in naked f2 RNA, while f2 capsid proteins may stick on the host which was described by Olivieri et al.[37]

Iodine and iodophors

Iodine as disinfectant is widely used while on comparison found to be feeble than chlorine but found to exhibit antimicrobial activity. Iodine is used as aqueous or alcoholic solutions from many days as antiseptics; they produce annoyance and unnecessary tint. The solutions in water are usually not stable; there are seven iodine species which are in solution form has complex equilibrium, with molecular iodine (I2) which is accountable for antiinfectious usefulness.[38] The discovery of iodophores (”iodine carriers” or “iodine-releasing agents”) removed these problems; the examples of iodophores are povidone-iodine and poloxamer-iodine which are mostly used as antiseptics and disinfectants. The multiplexes of iodine and a solubilizing mediator or hauler forms iodophors, which performs as a basin of the lively “free” iodine.[38]

The actual mechanism of iodine is unknown, but its antimicrobial action at low concentration is rapid like chlorine. Iodine works by quickly entering into microbes[39] and hits the main parts of proteins (specially the sulfur-containing amino acids),[38],[40] nucleotides, and fatty acids,[38],[41] that terminates in cell destruction.[38] The shallow proteins of enclosed viruses are attacked by iodine likewise to bacteria, but when they react with unsaturated carbon bonds they may subvert lipoidal membrane.[42]

 Silver Compounds



Silver compounds were used as antimicrobial agents for many years in different forms.[43] Even though silver metal, acetate, or nitrate salt of silver and silver protein possess germicidal activity, are marked in Martindale, The Extra Pharmacopoeia, silver compound which is mostly used in present time is silver sulfadiazine (AgSD).[44] Nowadays, the use of silver compounds is extended to avoid the blisters and eye contaminations and to wipe out moles.

Silver nitrate

The mechanism of silver ions is strongly associated with its contact with thiol (sulfydryl,-SH) groups.[45] Liau et al. described that cysteine like amino acids and sodium thioglycolate like compounds which is having sulfydryl groups deactivated the action of silver nitrate counter to P. aeruginosa.[46] These studies explained that contact of Ag + with thiol species in enzymes and proteins has an important part in microbial cell death, while other cellular machineries can be concerned. Virucidal properties may be too described by interaction to-SH groups.[47]

Silver sulfadiazine

It is basically a blend of silver and sulfadiazine which are antibacterial agents. The antibacterial action of AgSD is due to only one compound or an effect of both compounds is a questionable and has been posed frequently. A broad spectrum of activity has been shown by AgSD and develops surface and membrane blebs in vulnerable bacteria unlike silver nitrate.[48] Chemically, Fox[49] described a polymeric structure of AgSD consists of six silver atoms joined to six sulfadiazine groups by the association of the silver ions to the nitrogen of the sulfadiazine pyrimidine ring. Microbial inhibition would be accomplished by inhibiting transcription when silver fixes to adequate base pairs in the DNA helix. Likewise, AgSD binds to phage DNA which described its antiphage properties.[50] Evidently, the exact working of AgSD is yet to be explained.

 Peroxygens



Hydrogen peroxide

Hydrogen peroxide (H2O2) is an extensively used for disinfection, sterilization, and antiseptic. It is available commercially as a rich and colorless fluid fluctuating from 3% to 90% of concentration. H2O2 is an eco-friendly product that can form the harmless compounds, i.e., water and oxygen after degradation. H2O2 shows broad-spectrum activity against microbes.[51] It is more active in contrast to Gram-positive than Gram-negative bacteria. For sporicidal activity, more concentrations of H2O2 (10%–30%) and lengthier duration of interaction are necessary,[52] although the gaseous phase of H2O2 increased the action. H2O2 produces hydroxyl free radicals (•OH) which attacks necessary parts of the cell, including lipids, amino acid chains, and nucleic acid, and thus performs as an oxidant. It is explained that bare sulfhydryl groups and double bonds are mainly attacked.[51]

Peracetic acid

Peracetic acid also known as acetic acid, (CH3COOOH) widely used as antimicrobial. It works at low temperature and low concentration, i.e., <0.3%. It is reported as a potent anti-infective agent than H2O2. It acts as disinfectant or sterilizing agent for laboratory surface, glassware, and medical equipment.[51],[53] Acetic acid acts on the cellular membrane at its surface where it binds with the sulfhydryl groups and finally breaks the disulfide linkage and denatures proteins and enzymes similar to H2O2.[51]

 Phenols



The phenolic group containing antimicrobial agents are used as antiseptics, disinfectants, or preservatives for many years on the basis of the type of compounds. Despite being referred to as general protoplasmic poison, they also add to their whole activity due to membrane-active properties.[26] Demonstration by Pulvertaft and Lumb on a low concentration of phenols (0.032%, 32 mg/100 mL) and other (nonphenolic) agents lyses speedily rising cultures of many microbes such as Escherichia coli, staphylococci, and streptococci. It has given the conclusions that autolytic enzymes were not concerned.[54] The phenolics have additional activity against fungus or viruses. Their activity against fungus may impair the plasma membrane,[55] ensuing in seepage of intracellular constituents.

 Bis-Phenols



The bis-phenols consist of hydroxy groups having halogen, has two phenolic groups linked by numerous bridges.[56] They show a wide spectrum of activity still slight active against P. aeruginosa and molds. They block the growth of bacterial spores. Triclosan and hexachlorophane are the two agents which are used mainly for antibacterial detergents and hand cleaning. Cumulative and obstinate property on the skin has been shown by both compounds.[57]

Triclosan

Triclosan (5-Chloro-2-(2,4-dichlorophenoxy) phenol) shows action against Gram-positive bacteria.[58] By formulation effects, its inhibitory activity can be increased for Gram-negative bacteria and yeasts. For example, the permeability of the outer membrane can be increased when triclosan is combined with ethylenediaminetetraacetic acid.[59] The exact mechanism of triclosan is not still known, but it has been recommended that the attacking site is on the cytoplasmic membrane.[60]

Hexachlorophene

One more type of bis-phenol whose mechanism is widely studied, is hexachlorophene (hexachlorophane; 2,29-dihydroxy-3,5,6,39,59,69-hexachlorodiphenyl methane). It acts by blocking the electron transport chain and exert the antimicrobial action. The primary action of the hexachlorophene as studied with Bacillus megatherium.[61] It provokes escape, causes protoplast lysis, and reduces respiration. It has limited application in antiseptic products particularly for neonates due to concerns about its toxicity, even though it has broad-spectrum efficacy.[62]

 Halophenols



The main halophenol which is used in antiseptic or disinfectant is chloroxylenol (4-chloro-3,5-dimethylphenol; p-chloro-m-xylenol). Chloroxylenol kills bacteria, while P. aeruginosa and many molds are exceedingly resistant. Halophenols is used widely over many years, but on the contrary, its mechanism has been studied very less. It affects the microbial membrane because of its phenolic property.[63]

 Quaternary Ammonium Compounds



The molecular structure of surface-active agents (surfactants) is divided into two groups, i.e., hydrophobic or hydrophilic, i.e., water repelling or attracting respectively. These agents are further divided into different types according to their chemical composition, i.e., cationic, anionic, nonionic, and ampholytic (amphoteric). Cationic components are the mostly used antiseptics and disinfectants, as demonstrated by quaternary ammonium compounds (QACs). They are also called as cationic detergents. There are various clinical uses of QACs such as preoperative disinfection of unbroken skin, application to mucous membranes, and disinfection of uncritical surfaces. QACs are tremendously used for cleaning hard surfaces and deodorization apart from having antimicrobial properties.[64]

It works by attacking at the cytoplasmic (inner) layer in bacteria or the plasma membrane in yeasts).[65] The QACs effects lipid, enveloped viruses such as human immunodeficiency virus and HBV but have no effect on nonenveloped viruses.[66]

 Vapor-Phase Sterilants



Liquid sterilant or vapor phase sterilization systems are used to sterilize many temperature subtle medical apparatuses and surgical materials (in particular glutaric dialdehyde, acetic acid, and H2O2) [Table 1]. Epoxyethane, methanal, and more newly discovered, H2O2 and acetic acid are commonly used active mediators in these “cold” systems. Although the activity of ethylene oxide and formaldehyde depends on lively concentration, temperature, duration of exposure, and relative humidity, they both are broad-spectrum alkylating agents.[67] These alkylating agents outbreak proteins, nucleic acids, and other organic compounds. Both agents are mainly reactive with sulfhydryl and other enzyme-reactive groups. Being mutagenic and explosive nature of ethylene oxide gas has the disadvantages but is not usually insensitive on susceptible equipment. Likewise, the nonexplosive nature of formaldehyde gas has the advantage but is not extensively applied in health care. H2O2 and acetic acid in the vapor phase are measured as extra active (as oxidants) at lesser concentrations than in the liquid form.[68]

 Effective Concentration of Disinfectants



The antiviral activities of domestic goods are analyzed by a procedure which was discovered to calculate the capacity of particular antiseptic and disinfectant products to deactivate murine coronavirus (MHV), a potential surrogate for SARS-CoV. This procedure was applied for calculating the antiviral activity by shaping the log reductions by means of the Reed and Muench TCID50 endpoint method. It was established that domestic disinfectant and antiseptic products, having 0.05% of triclosan, 0.12% of PCMX, 0.21% of sodium hypochlorite, 0.23% of pine oil, or 0.10% of a quaternary compound with 79% of ethanol, were all similarly effectual at deactivating MHV. It must be distinguished that this process can only be done on viruses that produce cytopathogenic effect in cultured cells and a sufficient quantity of incubation time permitted for disease to take place. In these methods, the cell was analyzed strongly in the existence and nonexistence of virus or active alone as well as during the incubation of both. When neutralization had occur to reduce the effects of toxicity of some of the actives on the NCTC clone 1469 cell line, then Sephadex columns were used. Biosafety level-2 (BSL-2) viruses were replaced by BSL-3 viruses because they contain protocols for surrogate viruses for the use of testing antiviral properties and for viruses that are unavailable for testing, or for viruses that cannot be cultured in vitro.[69],[70],[71] The possible mechanism of disinfectants is shown in [Figure 1].{Figure 1}

 Conclusion



In this critical time, coronavirus is spreading rapidly in the human population of the world. There is no reliable cure to inhibit the growth of this deadly virus at this time. So, the application of disinfectant to inhibit the growth of viruses is the only cure to break the chain. There are wide ranges of disinfectants available in the market. But the concern must be taken to select the top merchandise for the particular use. The criteria for selecting the best product are done by calculating the activity against key pathogens and matching this result with statistics on toxicity, resources compatibility, and expenditure.

Acknowledgment

The authors thank GLA University, Mathura, UP, for the financial assistance and facilities.

Financial support and sponsorship

The financial assistance and facilities are provided by GLA University, Mathura, UP.

Conflicts of interest

There are no conflicts of interest.

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