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Clinical efficacy of nitric oxide nasal spray (NONS) for the treatment of mild COVID-19 infection

Winchester et al., Journal of Infection, doi:10.1016/j.jinf.2021.05.009
May 2021  
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Improvement 42% Improvement Relative Risk Viral load 51% Nitric Oxide  Winchester et al.  EARLY TREATMENT  DB RCT Is early treatment with nitric oxide beneficial for COVID-19? Double-blind RCT 80 patients in the United Kingdom (Dec 2020 - Mar 2021) Greater improvement (p=0.0077) and improved viral clearance (p=0.001) c19early.org Winchester et al., J. Infection, May 2021 Favorsnitric oxide Favorscontrol 0 0.5 1 1.5 2+
RCT with 40 nitric oxide and 40 placebo patients in the UK, showing faster viral clearance and greater improvement with treatment.
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.
risk of no improvement, 42.0% lower, RR 0.58, p = 0.008, treatment 8 of 15 (53.3%), control 23 of 25 (92.0%), NNT 2.6.
viral load, 51.3% lower, relative load 0.49, p = 0.001, treatment 40, control 40, AUC relative mean change.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Winchester et al., 13 May 2021, Double Blind Randomized Controlled Trial, placebo-controlled, United Kingdom, peer-reviewed, 4 authors, study period 15 December, 2020 - 31 March, 2021.
This PaperNitric OxideAll
Remdesivir treatment and transient bradycardia in patients with coronavirus diseases 2019 (COVID-19)
Carlo Pallotto, Pierluigi Blanc, Sara Esperti, Lorenzo Roberto Suardi, Andrea Gabbuti, Francesca Vichi, Lorenzo Mecocci, Anna Degli Esposti, Piera Pierotti, Letizia Attala, Elena Salomoni, Filippo Baragli, Daniela Francisci, Massimo Antonio Di Pietro
Journal of Infection, doi:10.1016/j.jinf.2021.05.025
Remdesivir treatment and transient bradycardia in patients with coronavirus diseases 2019 (COVID-19) Dear Editor,
Declaration of Competing Interest The authors report no potential conflicts of interest. Declaration of Competing Interest The authors declare no conflict of interest. Andrade Pereira, Rayana de Castro da Paz and Regiane Tigulini de Souza Jordão insightful discussions on the best way to present the data of this manuscript. Funding The authors received no specific funding for this work. Supplementary materials Supplementary material associated with this article can be found, in the online version, at doi: 10.1016/j.jinf.2021.05.012 . Supplementary materials Supplementary material associated with this article can be found, in the online version, at doi: 10.1016/j.jinf.2021.05.007 . Conflict of interest statement No conflict of interest to declare. Conflict of interest The authors declare that they have no conflict of interest. Ethics PHE has legal permission, provided by Regulation 3 of The Health Service (Control of Patient Information) Regulations 2002, to process patient information for national surveillance of communicable diseases. Specific ethical approval was not required for this surveillance work. Author's contributions HW, SE, IH, SR, KB and GA wrote the manuscript, with input from MR. GA, KB and MR contributed to conceptualization, funding acquisition and project administration. HW performed statistical analysis. EC, AL, CT, CC collated vaccine uptake statistics. EL, IH, Author contributions All authors contributed to the study concept and design...
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