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0 0.5 1 1.5 2+ Mortality 14% Improvement Relative Risk Nitric Oxide  Poonam et al.  VENTILATED PATIENTS Is late treatment with nitric oxide beneficial for COVID-19? Retrospective 103 patients in the USA (March - June 2020) Study compares with epoprostenol, results vs. placebo may differ Lower mortality with nitric oxide (not stat. sig., p=0.095) Poonam et al., PLOS ONE, June 2022 Favors nitric oxide Favors epoprostenol

Nitric oxide versus epoprostenol for refractory hypoxemia in Covid-19

Poonam et al., PLOS ONE, doi:10.1371/journal.pone.0270646
Jun 2022  
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Retrospective 103 mechanically ventilated patients, 41 treated with inhaled nitric oxide, and 62 with inhaled epoprostenol, showing no significant difference in outcomes.
Targeted administration to the respiratory tract provides treatment directly to the typical source of initial SARS-CoV-2 infection and replication, and allows for rapid onset of action, higher local drug concentration, and reduced systemic side effects (early treatment may be more beneficial).
risk of death, 13.6% lower, RR 0.86, p = 0.10, treatment 32 of 41 (78.0%), control 56 of 62 (90.3%), NNT 8.1.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Poonam et al., 27 Jun 2022, retrospective, USA, peer-reviewed, 5 authors, study period 1 March, 2020 - 30 June, 2020, this trial compares with another treatment - results may be better when compared to placebo.
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This PaperNitric OxideAll
Nitric oxide versus epoprostenol for refractory hypoxemia in Covid-19
Pai B H Poonam, Rebecca Koscik, Trong Nguyen, Shefali Rikhi, Hung-Mo Lin
PLOS ONE, doi:10.1371/journal.pone.0270646
Objective To compare the efficacy and outcomes with inhaled nitric oxide (iNO) and inhaled epoprostenol (iEPO) in patients with refractory hypoxemia due to COVID-19. Design Retrospective Cohort Study. Setting Single health system multicenter academic teaching hospitals. Patients OR subjects Age group of 18-80 years admitted to the medical ICU. Interventions Mechanically ventilated patients with COVID-19 infection, who
Supporting information S1
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Late treatment
is less effective
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