High Concentrations of Nitric Oxide Inhalation Therapy in Pregnant Patients With Severe Coronavirus Disease 2019 (COVID-19)

Fakhr, Bijan Safaee; Wiegand, Steffen B.; Pinciroli, Riccardo; Gianni, Stefano; Morais, Caio César Araújo; Ikeda, Toshihide; Miyazaki, Yusuke; Marutani, Eizo; Fenza, Raffaele Di; Larson, Grant; Parcha, Vibhu; Gibson, Lauren E.; Chang, Marvin G.; Arora, Pankaj; Carroll, Ryan W.; Kacmarek, Robert M.; Ichinose, Fumito; Barth, William H.; Kaimal, Anjali J; Hohmann, Elizabeth L.; Zapol, Warren M.; Berra, Lorenzo

doi:10.1097/aog.0000000000004128

Cited by 75 publications

(50 citation statements)

References 15 publications

(16 reference statements)

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“…Five of six patients had two negative test results by nasopharyngeal swab for SARS-CoV-2 within 28 days from admission. The result of the study showed that 160–200 ppm iNO appeared to be well tolerated, and might benefit pregnant patients with hypoxic respiratory failure ( Table 1 ) [ 97 ].…”

Section: Application Of No In Clinical Treatmentmentioning

confidence: 99%

The role of NO in COVID-19 and potential therapeutic strategies

Fang

Jiang

et al. 2021

Free Radical Biology and Medicine

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Nitric oxide (NO) is a free radical playing an important pathophysiological role in cardiovascular and immune systems. Recent studies reported that NO levels were significantly lower in patients with COVID-19, which was suggested to be closely related to vascular dysfunction and immune inflammation among them. In this review, we examine the potential role of NO during SARS-CoV-2 infection from the perspective of the unique physical, chemical and biological properties and potential mechanisms of NO in COVID-19, as well as possible therapeutic strategies using inhaled NO. We also discuss the limits of NO treatment, and the future application of this approach in prevention and therapy of COVID-19.

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Section: Application Of No In Clinical Treatmentmentioning

confidence: 99%

The role of NO in COVID-19 and potential therapeutic strategies

Fang

Jiang

et al. 2021

Free Radical Biology and Medicine

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“…High-dose inhaled nitric oxide (160-200 ppm) has demonstrated antimicrobial effects against bacteria and viruses (including SARS-CoV), and is used as an adjunct treatment for acute respiratory distress syndrome and pulmonary hypertension. A case series of pregnant patients with severe COVID-19 treated with high-dose nitric oxide demonstrated improvement in hypoxemia and tachypnea with no adverse neonatal effects 72 .…”

Section: Experimental Drugs For Covid-19 In the Setting Of Clinical Tmentioning

confidence: 98%

Pregnancy and COVID‐19: pharmacologic considerations

D’Souza

Ashraf

Rowe

et al. 2021

Ultrasound in Obstet & Gyne

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Medline, Embase, the Cochrane databases, CINAHL and Scopus were searched from inception until May 14, 2020 using MeSH terms and free text search terms related to "coronavirus infections", "pregnancy", "breastfeeding". This was supplemented with targeted searches of general medical and obstetric journals for publications related to routine, off-label, and investigational medications used in COVID-19 patients either for symptomatic relief or in the context of clinical trials, and discussions with international experts. In addition, we reviewed product monographs of all drugs, and conducted targeted literature searches involving the use of each drug in pregnant women. Finally, clinical practice recommendations were summarized from pregnancy guidelines of international societies and ongoing trials were reviewed from three clinical trial registries-www.clinicaltrials.gov, Australian New Zealand Clinical Trials Registry (ANZCTR) and the World Health Organization International Clinical Trials Registry Platform (ICTRP). Given the limited experience with the management of COVID-19, research letters, editorials, commentaries, opinion pieces and special communications were included. No language restrictions were applied.

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“…Ongoing clinical trials use higher doses of iNO at 80 ppm and even short periods of 200 ppm in a small group of pregnant patients infected with COVID-19 without reported side effects. 5 In addition, we do not know at which point in time the pharmacodynamic effect of iNO would be most beneficial.…”

Section: E D I T O R I a Lmentioning

confidence: 99%