Cold Atmospheric Plasma Applications in Viral Inactivation: Systematic Review and Metanalysis

Abstract This work is a systematic review conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A predefined protocol was followed to ensure a transparent, reproducible, and methodologically rigorous selection and analysis of the available literature on the use of cold plasma for viral inactivation. Cold atmospheric plasma (CAP) technology has emerged as a promising tool for combating viruses. This study presents a systematic review of current knowledge regarding CAP applications in virology. A comprehensive search was conducted across Scopus and Web of Science databases, including studies published between 2000 and 2024 that explored the use of CAP in virology. Following the guidelines outlined by PRISMA, 160 articles were identified and categorized into six categories. The analysis highlighted a notable increase in publications within this field since 2020, coinciding with the emergence of COVID-19. Geographically, the United States emerged as the leading contributor to research in this area, accounting for 21.9% of the publications. Among the identified articles, 20.6% were classified as reviews, while the remaining 79.4% comprised research studies. Data extraction focused on publication year, last author’s country affiliation, CAP source type, targeted applications, and investigated virus species. Fundamental research constituted the largest category of articles (34.4%), followed by studies exploring surface decontamination via CAP technology (18.8%). Dielectric barrier discharges (DBDs) were identified as the most prevalent CAP source employed in the studies, representing 26% of all cases. Analysis of the included experimental articles showed investigations encompassing 42 distinct viral species. RNA viruses emerged as the most extensively studied group, accounting for 76.2% of the research focus. The findings of this systematic review demonstrate the effectiveness of CAP in inactivating a broad spectrum of viruses. This includes both enveloped and non-enveloped viruses and DNA and RNA viruses affecting humans, animals, and plants. CAP-mediated viral inactivation is likely mediated by a multiplicity mechanism involving direct damage to viral particles, viral replication disruption, and host immune response modulation.