May 4 |
Nitric Oxide for COVID-19: real-time meta analysis of 13 studies | |
| Significantly lower risk is seen for cases and viral clearance. 6 studies from 5 independent teams in 5 countries show significant benefit. Meta analysis using the most serious outcome reported shows 30% [1‑50%] lower risk. Res.. | ||
Mar 13 |
et al., Journal of Clinical Medicine, doi:10.3390/jcm14061931 | Association of Endothelial Nitric Oxide Synthase Polymorphisms with Clinical Severity in Patients with COVID-19 |
| Retrospective 178 COVID-19 patients examining the association between NOS3 genetic polymorphisms (G894T and 27-bp VNTR 4b/a) and disease severity. Overall, no statistically significant associations were found between NOS3 genotypes and CO.. | ||
Feb 11 |
et al., Viruses, doi:10.3390/v17020244 | Systolic Pulmonary Artery Pressure as Long-Term Mortality Predictor in Elderly Critically Ill with Severe COVID-19 Pneumonia |
| 23% lower mortality (p=0.33). Retrospective 130 elderly (≥70 years) critically ill COVID-19 patients showing no significant difference in long-term mortality with nitric oxide. | ||
Oct 26 2024 |
et al., Antioxidants, doi:10.3390/antiox13111301 | Potential Beneficial Role of Nitric Oxide in SARS-CoV-2 Infection: Beyond Spike-Binding Inhibition |
| In Vitro study showing that nitric oxide (NO) inhibits SARS-CoV-2 spike protein binding to ACE2 and reduces ACE2 enzymatic activity. Authors showed that NO donors DETA-NONOate (DETA-NO) and S-nitrosoglutathione (GSNO) significantly decrea.. | ||
Jul 26 2024 |
et al., Scientific Reports, doi:10.1038/s41598-024-68055-w | A safety evaluation of intermittent high-dose inhaled nitric oxide in viral pneumonia due to COVID-19: a randomised clinical study |
| 64% lower need for oxygen therapy (p=0.03) and 41% shorter hospitalization (p=0.24). RCT 35 hospitalized patients with viral pneumonia (34 with COVID-19) showing improved recovery with high-dose inhaled nitric oxide (iNO) treatment. The treatment group received intermittent inhalations of 150 ppm iNO for 40 minutes, 4 tim.. | ||
Dec 15 2023 |
et al., American Journal of Respiratory and Critical Care Medicine, doi:10.1164/rccm.202304-0637OC | High-Dose Inhaled Nitric Oxide in Acute Hypoxemic Respiratory Failure Due to COVID-19: A Multicenter Phase II Trial |
| 23% lower mortality (p=0.36), 30% lower progression (p=0.67), and 83% improvement (p=0.01). RCT 193 mechanically ventilated COVID-19 patients showing improved oxygenation at 48 hours but no difference in mortality with high-dose (80ppm) inhaled nitric oxide (NO) for 48 hours. The NO group had a higher proportion attaining PaO2/F.. | ||
Dec 15 2023 |
et al., Frontiers in Immunology, doi:10.3389/fimmu.2023.1284148 | IFN-γ-mediated control of SARS-CoV-2 infection through nitric oxide |
| In vitro study showing that treatment with interferon-gamma (IFN-γ) inhibits SARS-CoV-2 infection in simian Vero E6 and human lung epithelial cell lines. The IFN-γ-triggered antiviral effect against SARS-CoV-2 is mediated through the endo.. | ||
Nov 1 2023 |
et al., Medical Gas Research, doi:10.4103/2045-9912.385414 | Saying No to SARS-CoV-2: the potential of nitric oxide in the treatment of COVID-19 pneumonia |
| Review of nitric oxide (NO) in the treatment of COVID-19. Authors summarizes evidence from in vitro studies suggesting NO has direct antiviral effects against SARS-CoV-2 as well as immune modulating and pulmonary protective effects. Small.. | ||
Oct 2 2023 |
et al., Frontiers in Microbiology, doi:10.3389/fmicb.2023.1277552 | Inhaled nitric oxide: can it serve as a savior for COVID-19 and related respiratory and cardiovascular diseases? |
| Review of inhaled nitric oxide (iNO) as a therapy for COVID-19 and related respiratory and cardiovascular diseases. Nitric oxide is an important signaling molecule produced by nitric oxide synthases that regulates various physiological pr.. | ||
Jun 24 2023 |
et al., The American Journal of Medicine, doi:10.1016/j.amjmed.2023.05.021 | The Efficacy of Nitric Oxide Generating Lozenges on Outcome in Newly Diagnosed COVID-19 Patients of African American and Hispanic Origin |
| 1% higher progression (p=1) and 11% faster recovery (p=0.3). RCT 524 outpatients in the USA for a nitric oxide generating lozenge, showing no significant difference in combined hospitalization, ICU admission, intubation, dialysis, and death. There were only 3 events in each arm, all occuring in 202.. | ||
Feb 3 2023 |
et al., Microorganisms, doi:10.3390/microorganisms11020397 | Pleiotropic Functions of Nitric Oxide Produced by Ascorbate for the Prevention and Mitigation of COVID-19: A Revaluation of Pauling’s Vitamin C Therapy |
| Extensive review of vitamin C and nitric oxide focusing on the potential antiviral activity of vitamin C for SARS-CoV-2 via the production of nitric oxide. Authors note that vegetables are a major dietary source of nitrate, and that dieta.. | ||
Oct 3 2022 |
et al., Critical Care, doi:10.1186/s13054-022-04158-y | Evaluation of inhaled nitric oxide (iNO) treatment for moderate-to-severe ARDS in critically ill patients with COVID-19: a multicenter cohort study |
| 40% higher mortality (p=0.1). Retrospective 815 COVID-19 ICU patients in Saudi Arabia, showing significant improvement in oxygenation. There was no significant difference in mortality, and ICU and hospitalization time was longer. | ||
Aug 24 2022 |
et al., Nitric Oxide, doi:10.1016/j.niox.2022.08.003 | Utility of NO and H2S donating platforms in managing COVID-19: Rationale and promise |
| Extensive review of the mechanisms of action and potential benefits of nitric oxide and hydrogen sulfide for SARS-CoV-2 and other viral infections. | ||
Jul 7 2022 |
et al., Obstetrics & Gynecology, doi:10.1097/AOG.0000000000004847 | High-Dose Inhaled Nitric Oxide for the Treatment of Spontaneously Breathing Pregnant Patients With Severe Coronavirus Disease 2019 (COVID-19) Pneumonia |
| 68% lower ventilation (p=0.08) and 39% lower ICU admission (p=0.28). Retrospective 71 hospitalized patients in Israel, 20 treated with inhaled nitric oxide, showing no significant differences. | ||
Jun 29 2022 |
et al., The Lancet Regional Health - Southeast Asia, doi:10.1016/j.lansea.2022.100036 | SARS-CoV-2 accelerated clearance using a novel nitric oxide nasal spray (NONS) treatment: A randomized trial |
| 68% greater improvement (p=0.08) and 20% improved viral clearance (p<0.0001). RCT with 153 patients treated with a nitric oxide nasal spray, and 153 placebo patients, showing faster viral clearance with treatment. NO generated by a nasal spray (NONS) self-administered six times daily as two sprays per nostril (0.45.. | ||
Jun 27 2022 |
et al., PLOS ONE, doi:10.1371/journal.pone.0270646 | Nitric oxide versus epoprostenol for refractory hypoxemia in Covid-19 |
| 14% lower mortality (p=0.1). Retrospective 103 mechanically ventilated patients, 41 treated with inhaled nitric oxide, and 62 with inhaled epoprostenol, showing no significant difference in outcomes. | ||
May 4 2022 |
et al., The American Journal of Emergency Medicine, doi:10.1016/j.ajem.2022.04.052 | Safety and practicality of high dose inhaled nitric oxide in emergency department COVID-19 patients |
| 179% higher ventilation (p=1), 21% lower hospitalization (p=1), and 38% worse results (p=0.72). Early terminated RCT with 47 ER patients in the USA, less than 12 days of symptoms, showing no significant difference in outcomes with a single high-dose administration of inhaled nitric oxide by mask, 250ppm for 30 min. | ||
Apr 30 2022 |
Retrospective clinical study for COVID-19 prevention after exposure | |
| 75% fewer cases (p<0.0001). PEP retrospective 625 university students in Thailand offered nitric oxide nasal spray, showing significantly lower cases for students that chose to use the treatment. | ||
Jan 28 2022 |
et al., Frontiers in Drug Delivery, doi:10.3389/fddev.2023.1164671 (date from preprint) | On a model-based approach to improve intranasal spray targeting for respiratory viral infections |
| Computational fluid dynamics study of nasal spray administration in 2 subjects showing 100x improvement in nasopharyngeal drug delivery using a new spray placement protocol. The study also found the optimal droplet size range for nasophar.. | ||
May 13 2021 |
et al., Journal of Infection, doi:10.1016/j.jinf.2021.05.009 | Clinical efficacy of nitric oxide nasal spray (NONS) for the treatment of mild COVID-19 infection |
| 42% greater improvement (p=0.008) and 51% improved viral clearance (p=0.001). RCT with 40 nitric oxide and 40 placebo patients in the UK, showing faster viral clearance and greater improvement with treatment. | ||
Apr 20 2021 |
et al., Infectious Microbes and Diseases, doi:10.1097/IM9.0000000000000079 (date from preprint) | Clinical Efficacy of Inhaled Nitric Oxide in Preventing the Progression of Moderate to Severe COVID-19 and Its Correlation to Viral Clearance: Results of a Pilot Study |
| 90% lower mortality (p=0.03), 90% lower ventilation (p=0.03), 42% greater improvement (p=0.47), and 64% faster viral clearance (p=0.005). RCT 29 ICU patients in India, showing improved clinical outcomes and faster viral clearance with inhaled nitric oxide treatment. The treatment group was younger (mean 54 vs. 66) and had more patients on NIV at baseline (29% vs. 18%). | ||
Jan 31 2021 |
et al., Clinical Medicine Insights: Circulatory, Respiratory and Pulmonary Medicine, doi:10.1177/11795484211047065 | Inhaled Nitric Oxide via High-Flow Nasal Cannula in Patients with Acute Respiratory Failure Related to COVID-19 |
| 54% higher mortality (p=0.25) and 27% higher ventilation (p=0.26). Retrospective 272 acute respiratory failure patients in the USA treated with high-flow nasal cannula, 66 treated with inhaled nitric oxide, showing increased mortality with inhaled nitric oxide. There were significant differences in the u.. | ||
Nov 12 2020 |
et al., Critical Care, doi:10.1186/s13054-020-03371-x | Inhaled nitric oxide for critically ill Covid-19 patients: a prospective study |
| Retrospective 34 ICU patients in France treated with inhaled nitric oxide, showing 65% had an increase in PaO2/FiO2 of >20% 30 min following administration. | ||
Oct 31 2020 |
et al., Redox Biology, doi:10.1016/j.redox.2020.101734 | Mitigation of the replication of SARS-CoV-2 by nitric oxide in vitro |
| In Vitro study showing that nitric oxide can inhibit the replication of SARS-CoV-2 in Vero E6 cells, and identifying the SARS-CoV-2 main protease as a target for nitric oxide. | ||
Jun 23 2020 |
et al., Nitric Oxide, doi:10.1016/j.niox.2020.06.005 | Nitric oxide dosed in short bursts at high concentrations may protect against Covid 19 |
| Hypothesis that reduced incidence of COVID-19 cases for smokers in some studies is due to bursts of high concentrations of nitric oxide during smoking. | ||
Jul 15 2002 |
et al., American Journal of Respiratory and Critical Care Medicine, doi:10.1164/rccm.200202-138BC | Humming Greatly Increases Nasal Nitric Oxide |
| Study of 10 healthy subjects showing that humming increased nasal nitric oxide (NO) levels 15 fold compared to quiet exhalation, likely due to increased sinus ventilation and gas exchange between the sinuses and nasal cavity. In a two-com.. | ||
Jun 1 1999 |
et al., Archives of Otolaryngology–Head & Neck Surgery, doi:10.1001/archotol.125.6.682 | Nitric Oxide Accumulation in the Nonventilated Nasal Cavity |
| Analysis of nitric oxide concentrations in the nonventilated nasal cavity, showing increasing levels with time. Results indicate that nitric oxide levels can be increased with breathing techniques. | ||
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