BACKGROUND: COVID-19 still represents a threat to public health. In this sense, antiseptic mouthwashes have been suggested to reduce cross-contamination and community transmission. MATERIAL AND METHODS: This systematic review and meta-analysis aimed to synthesize the evidence on the effectiveness of povidone-iodine (PVP-I), cetylpyridinium chloride (CPC) and chlorhexidine (CHX) mouthwashes in reducing SARS-COV-2 viral load in the saliva of adults diagnosed with COVID-19. After the systematic search in five electronic databases, 16 clinical trials published until June 2023 were analyzed. Of these, 6 were included in the meta-analysis. RESULTS: The standardized mean difference (SMD) was reported with its corresponding 95% confidence intervals (95%CI). An overall SMD of 0.51 (95%CI: -0.29 to 1.32
I² = 46.0%
CONCLUSIONS: The findings indicate a non-significant effect of mouthwashes on reducing viral load when all types were evaluated together. Separately, only PVP-I showed a significant reduction in viral load with a low level of certainty of evidence, while for CPC and CHX the reduction was not significant, with a low and very low level of certainty of evidence, respectively.