Coronavirus disease 2019 (COVID-19) is a contagious respiratory and vascular disease that continues to spread among people around the world, mutating into new strains with increased transmission rates, such as the delta variant. The scientific community is struggling to discover the link between negative COVID-19 outcomes in patients with preexisting conditions, as well as identify the cause of the negative clinical patient outcomes (patients who need medical attention, including hospitalization) in what seems like a widespread range of COVID-19 symptoms that manifest atypically to any preexisting respiratory tract infectious diseases known so far. Having successfully developed a nutritional formulation intervention based on nitrate, a nitric oxide precursor, the authors hypothesis is that both the comorbidities associated with negative clinical patient outcomes and symptoms associated with COVID-19 sickness are linked to the depletion of a simple molecule: nitric oxide.
The main objective of this randomized controlled trial was to analyze the acute effects of a nitrate-based nutritional formula on peripheral oxygen saturation (SpO2), patient-reported outcomes, and safety indices in patients with acute COVID-19 infection. The participants completing the protocol for the trial (n = 71) were allocated in a double-blind design to receive either a multicomponent nutritional formula (containing 1200 mg of potassium nitrate, 200 mg of magnesium, 50 mg of zinc, and 1000 mg of citric acid), or a placebo (2.5 g of inulin) during a 72-h monitoring period. All participants were requested to take an intervention (four capsules; weight of each capsule was ~2.5 g) every 4 h during the intervention period. A two-way mixed model ANOVA with repeated measures revealed a significant difference in SpO2 between interventions (P = 0.007). As many as 30 out of 38 patients (78.9%) receiving nitrate-based nutritional formula, who all started the treatment with SpO2 ≤ 95%, finished the intervention with SpO2 of at least 95% at 72-h follow-up, whereas in the placebo group, 13 patients out of 33 (39.4%) finished the trial with SpO2 of at least 95% (P < 0.05). The hospital admission rate after the 72-h follow-up was 21.1% in patients receiving nitrate-based formula compared to 33.3% in the placebo group (P = 0.25). The nitrate-based formula might be recognized as a potent strategy to tackle hypoxemia and concomitant features of the COVID-19 pandemic. In conclusion, it appears that the novel nitrated-based nutritional formulation described here was able to improve oxygen saturation and clinical outcomes in COVID-19 patients. Although the exact mechanism of action remains unknown, the nitrate-based formula might be recognized as a potent, safe, and convenient strategy to tackle hypoxemia and concomitant features of the COVID-19 pandemic.
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