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Nitric Oxide for COVID-19
11 studies from 164 scientists
2,201 patients in 6 countries
Statistically significant lower risk for cases and viral clearance.
5 studies from 4 independent teams in 4 countries show statistically significant improvements.
COVID-19 Nitric Oxide studies. Apr 2024.
0 0.5 1 1.5+ All studies 27% Mortality -4% Hospitalization 21% Cases 75% Viral clearance 43% RCTs 37% RCT mortality 55% Prophylaxis 75% Early 44% Late -5% Favorsnitric oxide Favorscontrol
Di Fenza
Nitric Oxide has been officially adopted in 10 countries. Submit updates/corrections.
Apr 11
Covid Analysis Nitric Oxide for COVID-19: real-time meta analysis of 11 studies
Statistically significant lower risk is seen for cases and viral clearance. 5 studies from 4 independent teams in 4 countries show statistically significant improvements. Meta analysis using the most serious outcome reported shows..
Dec 15
Di Fenza 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
Silva 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
Zhang 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
Zhao 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
Bryan 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
Yamasaki 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
Al Sulaiman 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
Oza 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
Valsecchi 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
Tandon 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
Poonam 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
Strickland 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
SaNOtize 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.
May 13
Winchester 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
Moni 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
Chandel 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
Abou-Arab 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
Akaberi 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
Hedenstierna 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
Weitzberg 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
Chatkin 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.
Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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