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NOVEL CORONAVIRUS: Allergen or Not An Allergen?

Not An Allergen

NOVEL CORONAVIRUS (SARS-CoV-2)

Please note that this page is a summary of what we currently know about novel coronavirus, COVID-19, and skin concerns. As of the time of this writing, skin lesions were beginning to be described in COVID-19. Avoiding rashes and other skin problems from the irritants and contact allergens described below is important as they may be mistaken for the skin lesions of COVID-19. Because the virus is new and the understanding of it is evolving rapidly, this page may quickly become outdated. Refer to trusted sources such as the World Health Organization, Centers for Disease Control and Prevention, and your country’s department of health for up-to-date information about COVID-19.

Novel coronavirus caused a global pandemic, fear and uncertainty, economic instability, sickness, and death…but it is not a contact allergen. While it would never be on patch test trays, COVID-19 does teach us a few important things about how a pandemic can affect the skin and especially sensitive skins.

The virus is not dermatotropic (a virus that affects or is attracted to the skin) but its contagiousness has meant a necessary increase in more aggressive personal hygiene and disinfection, and an increase in contact with personal protective equipment (PPEs). Many people can suffer irritation and/or contact dermatitis due to the harm that alcohol, detergents and disinfectants can cause the hydro-lipid mantle of the skin. But it is health front liners who bear the brunt of skin issues. According to one study in Clinics and Dermatology, some of the skin concerns suffered by healthcare workers include “Pressure injury, contact dermatitis, itch, pressure urticaria, and exacerbation of pre-existing skin diseases, including seborrheic dermatitis and acne.” The most common skin complications seen are contact reactions — redness, burning, itching, barrier problems, scaling, and more — from the extended wear of PPEs:

  • Extended wear of gloves can lead to redness and other reactions due to contact dermatitis (especially to rubber or latex gloves) or the sustained exposure to the sweaty environment that the occlusion creates (the gloves create a sealed environment).
  • Hand washing is a concern for everyone but more so for front liners who wash their hands well over ten times a day.
  • Extended wear of goggles and masks in particular (especially with the heat and sweat of exertion and stress) can cause swelling, burning, itching, urticaria, contact dermatitis, and even acne.
  • Head covers and other occlusive equipment can trigger flare-ups of seborrheic dermatitis, folliculitis, and itching.
  • Heat and sweat can cause pressure urticaria. This is not an allergy but a form of physical urticaria.

Dermatologists may need to care for people hoping to prevent infection as well as health front liners who may develop skin complications due to their efforts to stay safe and care for others. Some possible ways to prevent or alleviate symptoms could be to prioritize allergen-free, irritant-free, and non-comedogenic products.

Cleanser:

Hair and body washes like Superwash have the added benefit of cleansing hands, hair, scalp, and body both gently (allergen-free) and thoroughly (contains acceptable concentrations of coconut-derived SLS, which is antimicrobial).

Facial Cleanser:

Now is the time for the gentlest options to offset the friction, occlusion, and allergen-exposure from prolonged use of PPEs.

Moisturizer and Barrier-Protection for Hands:

Apply emollients and barrier protective creams liberally onto hands following hand washing and before wearing PPE equipment.

Skin Calmers:

The Big, Brave Boo-Boo Balm and Red Better Calm-The-Heck-Down Balm provide non-steroidal quick relief and non-irritating disinfection for itching, redness, and lacerations. While steroids may occasionally be necessary, they are contact allergens and prolonged steroid use can worsen the skin and cause other health issues.

Disinfection Techniques with Moisturizing, Film-forming, Barrier-Protective Alternatives:

See another disinfection technique using the products listed above. Based on a review of clinical studies on virgin coconut oil and monolaurin as effective antivirals, antibacterials and antifungals, this technique could give damaged skin some relief and time to heal.

Other Skin Concerns:

Dermatology patients with auto-immune skin disorders with chronic inflammation such as psoriasis, lupus, atopic dermatitis, etc. may also require additional care. Many of these conditions are treated with biologicals which are immune suppressive. Check with your dermatologist on the latest recommendations regarding whether the administration of these biologics needs to be delayed.

It is important to emphasize that, to our knowledge as of this writing, monolaurin has not been tested on SARS-CoV-2 specifically (neither has alcohol). This information is compelling but needs validation on this particular virus. The available evidence seems to suggest similar efficacy to alcohol in destroying enveloped viruses and some coronaviruses. Follow your doctor’s instructions, and rely on trusted sources such as the World Health Organization, Centers for Disease Control and Prevention, and your country’s department of health. For a study review of VCO, monolaurin and other coconut oil derivatives as antivirals, antibacterials and antifungals, click here.

If you have a history of sensitive skin, don’t guess: random trial and error can cause more damage. Ask your dermatologist about a patch test.

To shop our selection of hypoallergenic products, visit vmvhypoallergenics.com. Need help? Ask us in the comments section below, or for more privacy (such as when asking us to customize recommendations for you based on your patch test results) contact us by email, or drop us a private message on Facebook.

For more:

On the prevalence of skin allergies, see Skin Allergies Are More Common Than Ever and One In Four Is Allergic to Common Skin Care And Cosmetic Ingredients.

To learn more about the VH-Rating System and hypoallergenicity, click here.

Main References: 

Regularly published reports on the most common allergens by the North American Contact Dermatitis Group and European Surveillance System on Contact Allergies (based on over 28,000 patch test results, combined), plus other studies. Remember, we are all individuals — just because an ingredient is not on the most common allergen lists does not mean you cannot be sensitive to it, or that it will not become an allergen. These references, being based on so many patch test results, are a good basis but it is always best to get a patch test yourself.

1. Warshaw, E.M., Maibach, H.I., Taylor, J.S., et al. North American contact dermatitis group patch test results: 2011-2012. Dermatitis. 2015; 26: 49-59.

2. W Uter et al. The European Baseline Series in 10 European Countries, 2005/2006–Results of the European Surveillance System on Contact Allergies (ESSCA). Contact Dermatitis 61 (1), 31-38.7 2009.

3. Wetter, DA et al. Results of patch testing to personal care product allergens in a standard series and a supplemental cosmetic series: An analysis of 945 patients from the Mayo Clinic Contact Dermatitis Group, 2000-2007. J Am Acad Dermatol. 2010 Nov;63(5):789-98.

4. Verallo-Rowell VM. The validated hypoallergenic cosmetics rating system: its 30-year evolution and effect on the prevalence of cosmetic reactions. Dermatitis 2011 Apr; 22(2):80-97.

5. Ruby Pawankar et al. World Health Organization. White Book on Allergy 2011-2012 Executive Summary.

6. Misery L et al. Sensitive skin in the American population: prevalence, clinical data, and role of the dermatologist. Int J Dermatol. 2011 Aug;50(8):961-7.

7. Warshaw EM1, Maibach HI, Taylor JS, Sasseville D, DeKoven JG, Zirwas MJ, Fransway AF, Mathias CG, Zug KA, DeLeo VA, Fowler JF Jr, Marks JG, Pratt MD, Storrs FJ, Belsito DV. North American contact dermatitis group patch test results: 2011-2012.Dermatitis. 2015 Jan-Feb;26(1):49-59.

8. Warshaw, E et al. Allergic patch test reactions associated with cosmetics: Retrospective analysis of cross-sectional data from the North American Contact Dermatitis Group, 2001-2004. J AmAcadDermatol 2009;60:23-38. 

9. Foliaki S et al. Antibiotic use in infancy and symptoms of asthma, rhinoconjunctivitis, and eczema in children 6 and 7 years old: International Study of Asthma and Allergies in Childhood Phase III. J Allergy Clin Immunol. 2009 Nov;124(5):982-9.

10. Kei EF et al. Role of the gut microbiota in defining human health. Expert Rev Anti Infect Ther. 2010 Apr; 8(4): 435–454.

11. Thavagnanam S et al. A meta-analysis of the association between Caesarean section and childhood asthma. Clin Exp Allergy. 2008;38(4):629–633.

12. Marks JG, Belsito DV, DeLeo VA, et al. North American Contact Dermatitis Group patch-test results, 1998 to 2000. Am J Contact Dermat. 2003;14(2):59-62.

13. Warshaw EM, Belsito DV, Taylor JS, et al. North American Contact Dermatitis Group patch test results: 2009 to 2010. Dermatitis. 2013;24(2):50-99.

14. Bogdanov I, Darlenski R, Hristakieva E, Manuelyan K. The rash that presents as a vesiculobullous eruption. Clin Dermatol. 2020;38(1):19–34. doi:10.1016/j.clindermatol.2019.10.012.

15. Darlenski R, Tsankov, N. Covid-19 pandemic and the skin – What should dermatologists know? Clin Dermatol. 2020 Mar 24. doi: 10.1016/j.clindermatol.2020.03.012 [Epub ahead of print]

Want more great information on contact dermatitis? Check out the American Contact Dermatitis SocietyDermnet New Zealand, and your country’s contact dermatitis association.


Laura is our “dew”-good CEO at VMV Hypoallergenics and eldest daughter of VMV’s founding dermatologist-dermatopathologist. She has two children, Madison and Gavin, and works at VMV with her sister CC and husband Juan Pablo (Madison and Gavin frequently volunteer their “usage testing” services). In addition to saving the world’s skin, Laura is passionate about health, inclusion, cultural theory, human rights, happiness, and spreading goodness (like a great cream!)

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Featured Healthy Living Skin

Study Review: Coconut Oil, Monolaurin & Other Derivatives As Antivirals

The quick summary:

There are multiple published clinical studies on the antimicrobial properties of virgin coconut oil (VCO) and its derivatives, and they’ve been around longer than you may think.

We asked a leading dermatologist and dermatopathologist, Dr. Vermén Verallo-Rowell, who is a specialist in contact dermatitis, psoriasis, and its secondary infections — and whose regularly-cited studies on virgin coconut oil and monolaurin have helped us understand their clinical, nutritional, and cosmetic applications — for a review of these studies to help us better understand how virgin coconut oil and its derivatives really hold up against some of the most common microbes.

Her review spanned laboratory and clinical disinfection studies on VCO and derivatives compared with alcohol since the 1970s.

It seems that VCO and its derivatives are as effective as alcohol in typical hand sanitizers but with some important differences.

Her detailed review follows below but this simple summary shares the highlights of how coconut derivatives compare against alcohol, the all-time classic against viruses.

1. Alcohol, at very high concentrations, kills viruses

Alcohol is virucidal, significantly so at 85%, less so at 70-80%. Check your hand sanitizer to make sure it that it contains alcohol at these concentrations.

2. VCO and its derivatives are as effective as 85% alcohol, but at much lower concentrations due to how they work

Alcohol works by denaturing the virus’s protein materials. VCO and its derivatives are as effective but they act in a different way: they act on lipids so they directly disintegrate the viral envelope, which destroys the rest of the virus.

Lauric acid monoglyceride as 2% monolaurin has been shown to kill not just viruses but also fungi as well as gram (+) and (-) bacteria, and some of their resistant strains.

3. Pros and cons of alcohol versus VCO and its derivatives

VCO, its derivatives, and alcohol all have immediate effects but alcohol evaporates quickly (is transient). VCO and its derivatives are lipids (fats). They stay longer on surface skin and mucosa, so their antimicrobial effects last longer.

VCO can also be used to gargle with, and our clinic and research center regularly prescribes monolaurin pellets to be taken orally as daily supplements.

A virtually-pure monolaurin (96%) in hand sanitizers and other leave-on products is an excellent alternative. Its studies are so consistent that VMV Hypoallergenics uses monolaurin in the majority of our products as part of our proprietary self-preserving system and to protect skins with compromised barrier functions (such as in psoriasis and eczema) from microbial colonization.

These products are more expensive than alcohol-based ones but their antiviral action on the breakdown of enveloped viruses and other microbes, combined with their moisturizing and longer-lasting effects, are desirable, especially with frequent use. These can be applied to hands and nostrils, including the inside mucosa that can be easily reached.

4. What about price?

If 80-85% alcohol is available, that’s great and usually very affordable. If not, and if clean water is available, a hand or body wash with sodium lauryl sulfate (SLS) or sodium laurel sulfate (SLES), is better to use than diluted alcohol. SLS and SLES are relatively cheap coconut oil derivatives made with lauric acid. They are often found as a saponifier in bar soaps (read ingredient labels for its presence) and in some hair and body washes. Just make sure to choose products with lower concentrations of SLS or SLES and with no allergens or irritants in the formulation. While not an allergen, SLS and SLES, just like alcohol, can be irritating (more so SLS than SLES) as their concentration increases.

As an alternative, VCO can be used. When we do medical outreaches, the doctors we work with teach patients to make their own coconut oil, if coconuts are more readily available than other options. We then instruct them to massage the VCO well — rubbing it into the skin — to help the lipases in non-/pathogenic microbes in the skin break down the VCO into its monoglycerides and fatty acids, especially into lauric acid and monolaurin. The slippery feel of the oil disappears quickly because 65% of its fatty acids are short to medium chain.

What about on 2019-nCoV (coronavirus)?

In January, 2020, The Potential of Coconut Oil and its Derivatives as Effective and Safe Antiviral Agents Against the Novel Coronavirus (nCoV-2019), a study by Professor Emeritus Dr. Fabian Antonio Dayrit and Dr. Mary Newport, explored “the potential use of coconut oil as a safe antiviral agent against the novel coronavirus.” It posed the question…

“Several researchers have been designing drugs to specifically target protease enzymes in coronavirus, but testing for these drugs is many months away. What if there is a treatment candidate against the coronavirus that might already be available and whose safety is already established?”

They continue: “Lauric acid (C12) and monolaurin, its derivative, have been known for many years to have significant antiviral activity. Lauric acid is a medium-chain fatty acid which makes up about 50% of coconut oil; monolaurin is a metabolite that is naturally produced by the body’s own enzymes upon ingestion of coconut oil and is also available in pure form as a supplement. Sodium lauryl sulfate, a common surfactant that is made from lauric acid, has been shown to have potent antiviral properties. Lauric acid, monolaurin, and sodium lauryl sulfate (which is also known as sodium dodecyl sulfate) are used in a wide range of products for their antiviral properties.”

How is monolaurin a compelling candidate for novel coronavirus?

Doctors Dayrit and Newport explain lauric acid and monolaurin’s antiviral mechanisms: “first, they cause disintegration of the virus envelope; second, they can inhibit late maturation stage in the virus replicative cycle; and third, they can prevent the binding of viral proteins to the host cell membrane.”

Monolaurin works by disintegrating the virus membrane.

Both the 2020 study and Dr. Verallo-Rowell’s review point to the antiviral studies of lauric acid and monolaurin from as early as 1979. A 1982 study by Hierholzer & Kabara “showed that monolaurin was able to reduce infectivity of 14 human RNA and DNA enveloped viruses in cell culture by >99.9%” with monolaurin working specifically by disintegrating the virus envelope (later validated by further studies; see review).

Because monolaurin works by preventing maturation, it prevents replication.

A 2001 study on fatty acids against the Junin virus (JUNV; the cause of Argentine hemorrhagic fever) showed that lauric acid was the most effective at inhibiting “a late maturation stage in the replicative cycle of JUNV.”

As a result, this may slow down the increase in viral load in the body.

Monolaurin prevents the virus from binding to our cells.

Instead of influencing protein synthesis in the viral membrane, lauric acid prevents binding to the host cell.

Doctors Dayrit and Newport cite a 1994 study showing that lauric acid prevented infectious vesicular stomatitis by preventing the viral proteins from binding to the healthy host’s cells’ membranes. Furthermore, removing the lauric acid removed the antiviral effect.

It is important to emphasize that, to our knowledge as of this writing, monolaurin has not been tested on nCoV-2019 specifically (neither has alcohol). This information is compelling but needs validation on this particular virus. The available evidence seems to suggest similar efficacy to alcohol in destroying enveloped viruses and some coronaviruses. Follow your doctor’s instructions, and rely on trusted sources such as the World Health Organization, Centers for Disease Control and Prevention, and your country’s department of health. For the study review of VCO, monolaurin and other coconut oil derivatives as antivirals, antibacterials and antifungals, continue reading. 

Study Review: Broad Spectrum Anti-Virals, -Bacterials, -Fungals From Coconut Oil And Its Derivatives by Vermén M. Verallo-Rowell, MD, FPDS, FAAD, FASDP, FADA

Since 2007, Dr. Verallo-Rowell has treated, disinfected, and prevented recurrences on H. simplex Virus 1 and 2, Verrucae, Molluscum contagiosum, and various other skin infections using 96% monolaurin in oral pellets, 2-4% monolaurin in topical preparations, and 1% monocaprin topical preparations, with high efficacy and very rare adverse reactions.

She often combines the use of these monolaurin products with the daily application of cold-pressed, organic virgin coconut oil (VCO) which, in addition to its broad-spectrum antimicrobial properties, has humectant, occlusive, lipid cell membrane and skin barrier repair capabilities, from its unique fatty acids and glycerin.

She also regularly uses 2-4% monolaurin in hand gels and in petrolatum for antibacterial, antiviral, and antifungal antisepsis.

The summary of her study review states: “Virgin coconut oil and its derivatives are shown in laboratory and translational clinical studies to have a broad-spectrum, antimicrobial effectivity on viruses, bacteria and fungi. Most of the studies are published in international, a few in regional journals. Still fewer are pilot trials that similarly show these antimicrobial effects against various organism types.”

Introduction to virgin coconut oil and its derivatives

“Like all vegetable oils, coconut oil (CO) is made up of triglycerides which have three fatty acids (FAs) linked to the three carbons in its core glycerin molecule.

Lipase enzymes of non-pathogenic microbes present normally in the skin, and pathogens that may invade it, break down the links, first to a di- then a mono-glyceride, and lastly, into its glycerin and three-fatty acid components.

VCO has about 50% Lauric acid, and 7% Capric acid. The monoglycerides of these two fatty acids have broad-spectrum antimicrobial effects as seen in a few pilot studies; and in laboratory studies and clinical trials published in international and regional journals since the 1970s.

In our studies, we use virgin coconut oil (VCO) that is cold pressed with no heat, certified organic, and freshly harvested to ensure purity, maximum content of important fatty acids, its monoglycerides, fatty acids, and its anti-oxidants .”

Monolaurin, Monocaprin and VCO Anti-Viral Laboratory and Clinical Studies

The antiviral activities of Lauric acid and monolaurin were first noted by Sands and co-worker in 1979. In 1982, monolaurin was shown to be highly antiviral, at times, at 10 times less concentration, than its Lauric Fatty acid. Five years later in 1987, monolaurin is confirmed as highly anti-viral at concentrations 10 times less than Lauric acid. This study also showed that both monolaurin and Lauric acid inactivate viruses by cell membrane disintegration. A 1994 study showed that Lauric acid had a dose-dependent, reversible inhibition of infectious vesicular stomatitis virus production. When Lauric acid was absent, this antiviral effect disappeared. Lauric acid did not influence viral membrane (M) protein synthesis, but prevented binding to the host cell membrane. In 1999, monocaprin was shown to be a feasible mucosal microbicide to prevent sexually transmitted infections such as Neisseria gonorrhea, Chlamydia and HIV.

In the 2000s, studies were published on coconut oil for HIV-AIDS (repeated in 2016 with forty HIV subjects with CD4+ T lymphocyte counts divided into a VCO group and control group (no VCO). The VCO group showed significantly higher average age CD4+ T lymphocyte counts versus control after 6 weeks. Monolaurin for Molluscum contagiosum (a skin virus), and monolaurin in a gel is highly active on repeated high viral loads of Simean immunodeficiency virus in macaques. A study in 2001 on saturated C10 to C18 fatty acids against JUNV (an enveloped virus and the causative agent of Argentine hemorrhagic fever) infection showed Lauric acid as the most active inhibitor. Mechanistic studies from transmission electron microscopic images from 2012 concluded that Lauric acid inhibited a late maturation stage in the replicative cycle of JUNV.

In 2007, monoglycerides were tested on respiratory syncytial virus (RSV) and human parainfluenza virus type 2 (HPIV2) at different concentrations, times, and pH levels, with monocaprin (even as low as 0.06-0.12%) showing the most activity against influenza A virus.

From 2015 onwards, studies show monolaurin’s efficacy in a wider range of viruses, from avian influenza virus in chickens, to the female genital tract in Rhesus macaques. Further studies show coconut oil and its derivatives as safe and effective antiviral compounds in both humans and animals against envelope viruses, causing complete envelopes, plasma membranes, and viral particles to disintegrate, lyse, and cause the death of cultured cells. Because of the antiviral and antibacterial protection that it provides to animals, coconut oil, as well as lauric acid and monolaurin, are used in farm animals and pets as veterinary feed supplements in chicken, swine and dogs.

Studies Reviewed:
  1. Sands JA, Auperin LD, Reinhardt A. Enveloped virus inactivation by fatty acid derivatives. Antimicrob Agents Chemother. 1979;15(1):134–136. doi:10.1128/aac.15.1.134.
  2. Hierholzer JC, Kabara JJ. In vitro effects of monolaurin compounds on enveloped RNA and DNA viruses. J Food Safety 1982;4:1–12.
  3. Thormar H et al. Inactivation of enveloped viruses and killing of cells by fatty acids and monoglycerides. Antimicrob Agents Chemother. 1987 Jan;31(1):27-31.
  4. Thormar H, Isaacs CE, Brown HR, Barshatzky MR, Pessolano T. Inactivation of Enveloped Viruses and Killing of Cells by Fatty Acids and Monoglycerides. Antimicrobial Agents and Chemotherapy, 1987; 31(1): 27-31.
  5. Hornung B, Amtmann E, Sauer G. Lauric acid inhibits the maturation of vesicular stomatitis virus. Journal of General Virology, 1994; 75: 353-361.
  6. Thormar H, Bergsson G, Gunnarsson E, et al. Hydrogels containing monocaprin have potent microbicidal activities against sexually transmitted viruses and bacteria in vitro. Sex Transm Infect. 1999;75(3):181–185. doi:10.1136/sti.75.3.181
  7. Kristmundsdóttir T, Arnadóttir SG, Bergsson G, Thormar H. Development and evaluation of microbicidal hydrogels containing monoglyceride as the active ingredient. Journal of Pharmaceutical Science, 1999; 88(10): 1011-1015.
  8. Dayrit CS. Coconut Oil in Health and Disease: Its and Monolaurin’s Potential as Cure for FOR HIV/AIDS. XXXVII Cocotech Meeting. Chennai, India. July 25, 2000.
  9. Bartolotta S, Garcí CC, Candurra NA, Damonte EB. Effect of fatty acids on arenavirus replication: inhibition of virus production by lauric acid. Archives of Virology, 2001; 146(4): 777-790.
  10. Chua EO, Verallo-Rowell VM. Coconut oil extract 2% Monolaurin cream in the treatment of Molluscum contagiosum. A randomized double-blind vehicle-controlled trial. Scientific Poster presentation Semi-Finalist. In Abstracts, World Congress of Dermatology October 1-5 2007, Buenos Aires, Argentina.
  11. Hilmarsson H, Traustason BS, Kristmundsdóttir T, Thormar H. Virucidal activities of medium- and long-chain fatty alcohols and lipids against respiratory syncytial virus and parainfluenza virus type 2: comparison at different pH levels. Archives of Virology 2007: 152(12):2225-36.
  12. Li Q, Estes JD, Schlievert PM, et al. Glycerol monolaurate prevents mucosal SIV transmission. Nature. 2009;458(7241):1034–1038. doi:10.1038/nature07831.
  13. Grant A, Seregin A, Huang C, Kolokoltsova O, Brasier A, Peters C, Paessler S. Junín Virus Pathogenesis and Virus Replication. Viruses, 2012; 4: 2317-2339.
  14. van der Sluis W. Potential antiviral properties of alpha-monolaurin. Poultry World. Downloaded from https://www.poultryworld.net/Nutrition/Articles/2015/12/Potential-antiviral-properties-of-alpha-monolaurin-2709142W/.
  15. Widhiarta KD. Virgin Coconut Oil for HIV – Positive People. Cord, 2016; 32 (1): 50-57.
  16. Kirtane AR, Rothenberger MK, Frieberg A, et al. Evaluation of vaginal drug levels and safety of a locally administered glycerol monolaurate cream in Rhesus macaques. Journal of Pharmaceutical Science 2017; 106(7):1821-1827.
  17. Baltić B, Starčević M, Đorđević J, Mrdović B, Marković R. Importance of medium chain fatty acids in animal nutrition. IOP Conf. Series: Earth and Environmental Science 2017; 85: 012048.
  18. Verallo-Rowell V.M., Katalbas S.S., Evangelista M.T., Dayrit J.F. Curr. Dermatol. Rep., 2018, 7: 24.
  19. Yan B, Chu H, Yang D, et al. Characterization of the Lipidomic Profile of Human Coronavirus-Infected Cells: Implications for Lipid Metabolism Remodeling upon Coronavirus Replication. Viruses. 2019;11(1):73. Published 2019 Jan 16. doi:10.3390/v11010073
  20. De Sousa ALM, Pinheiro RR, Araújo JF, et al. Sodium dodecyl sulfate as a viral inactivator and future perspectives in the control of small ruminant lentiviruses. Arquivos do Instituto Biológico, 2019; 86. Epub Nov 28, 2019.