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All Studies   Meta Analysis    Recent:   

High-Dose Inhaled Nitric Oxide for the Treatment of Spontaneously Breathing Pregnant Patients With Severe Coronavirus Disease 2019 (COVID-19) Pneumonia

Valsecchi et al., Obstetrics & Gynecology, doi:10.1097/AOG.0000000000004847
Jul 2022  
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0 0.5 1 1.5 2+ Mortality 58% Improvement Relative Risk Ventilation 68% ICU admission 39% Nitric Oxide  Valsecchi et al.  LATE TREATMENT Is late treatment with nitric oxide beneficial for COVID-19? Retrospective 71 patients in Israel (March 2020 - December 2021) Lower ventilation (p=0.075) and ICU admission (p=0.28), not sig. c19early.org Valsecchi et al., Obstetrics & Gynecol.., Jul 2022 Favors nitric oxide Favors control
Retrospective 71 hospitalized patients in Israel, 20 treated with inhaled nitric oxide, showing no significant differences.
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, 58.2% lower, RR 0.42, p = 1.00, treatment 0 of 20 (0.0%), control 1 of 51 (2.0%), NNT 51, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm).
risk of mechanical ventilation, 68.1% lower, RR 0.32, p = 0.08, treatment 2 of 20 (10.0%), control 16 of 51 (31.4%), NNT 4.7.
risk of ICU admission, 39.3% lower, RR 0.61, p = 0.28, treatment 5 of 20 (25.0%), control 21 of 51 (41.2%), NNT 6.2.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Valsecchi et al., 7 Jul 2022, retrospective, Israel, peer-reviewed, 20 authors, study period March 2020 - December 2021. Contact: lberra@mgh.harvard.edu.
This PaperNitric OxideAll
High-Dose Inhaled Nitric Oxide for the Treatment of Spontaneously Breathing Pregnant Patients With Severe Coronavirus Disease 2019 (COVID-19) Pneumonia
MD Carlo Valsecchi, MD, Bijan Dario Winterton, Bijan Safaee Fakhr, Ai-Ris Y. Collier, MD Ala Nozari, MD Jamel Ortoleva, MS Shivali Mukerji, MD Lauren E Gibson, MD Ryan W Carroll, MD Shahzad Shaefi, MD, Carolyn Riccardo Pinciroli, Carolyn La Vita, MD Jeanne B Ackman, MD Elizabeth Hohmann, MD Pankaj Arora, MD William H Barth Jr, MD Anjali Kaimal, MD Fumito Ichinose, MD Lorenzo Berra
Obstetrics & Gynecology, doi:10.1097/aog.0000000000004847
for the DELiverly oF iNO (DELFiNO) Network Collaborators* OBJECTIVE: To evaluate whether the use of inhaled nitric oxide (iNO) 200 improves respiratory function. METHODS: This retrospective cohort study used data from pregnant patients hospitalized with severe bilateral coronavirus disease 2019 (COVID-19) pneumonia at four teaching hospitals between March 2020 and December 2021. Two cohorts were identified: 1) those receiving standard of care alone (SoC cohort) and 2) those receiving iNO 200 for 30 minutes twice daily in addition to standard of care alone (iNO 200 cohort). Inhaled nitric
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Late treatment
is less effective
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