Nitric Oxide in the Treatment of COVID‐19: Nasal Sprays, Inhalants and Nanoparticles

Wright et al., Biochemistry Research International, doi:10.1155/bri/8846903, Oct 2025
42nd treatment shown to reduce risk in June 2022, now with p = 0.046 from 13 studies, recognized in 10 countries.
Lower risk for cases and viral clearance.
No treatment is 100% effective. Protocols combine treatments.
6,300+ studies for 210+ treatments. c19early.org
Review of nitric oxide (NO) as a therapeutic for COVID-19, focusing on its administration as a nasal spray, inhalant, or via nanoparticles. Clinical trials on nitric oxide nasal spray (NONS) have shown it to be an effective and safe therapy that significantly reduces SARS-CoV-2 viral load. Authors note that inhaled nitric oxide (iNO) has also been shown to improve oxygenation and respiratory outcomes in COVID-19 patients with varying severity, but with inconsistent survival benefits for severe patients. While iNO carries risks like methaemoglobin and nitrogen dioxide formation, authors found studies showing these levels remained within safe limits. The rationale for NO treatment is based on findings that COVID-19 patients often have decreased NO bioavailability, and NO is believed to inhibit the virus by S-nitrosylation of the host's ACE2 receptor or viral proteases.
Reviews covering nitric oxide for COVID-19 include1-6.
Wright et al., 13 Oct 2025, peer-reviewed, 3 authors. Contact: sophia.bryan04@uwimona.edu.jm.
Nitric Oxide in the Treatment of COVID‐19: Nasal Sprays, Inhalants and Nanoparticles
Amarley Wright, Donovan Mcgrowder, Sophia Bryan
Biochemistry Research International, doi:10.1155/bri/8846903
Although the World Health Organization has declared that the coronavirus disease (COVID-19) is not a public health emergency of international concern anymore, it has negatively impacted the world, and efective treatment for this pandemic remains a major priority. Vaccine efectiveness has been a matter of concern given the evolution of variants and subvariants of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Tus, continued protection against SARS-CoV-2 and its variants is still necessary and could work alone or in parallel with vaccinations to treat COVID-19 in the future. Further, fndings from in vitro and in vivo studies have noted the efectiveness of high dosages of nitric oxide (NO) as an antimicrobial agent against respiratory pathogens such as bacteria, viruses and fungi. NO has been previously utilized in the management of SARS-CoV and has shown a similar antiviral efect with SARS-CoV-2 in vivo and in vitro. Efective therapy with NO can be used to target several stages of COVID-19 infection to prevent transmission and progression of the disease. Te unique properties of NO allow this simple, gaseous molecule to be administered in various forms. NO can be used as an inhalant, in the form of NO donor drugs such as Snitrosothiols and more recently as NO-releasing nanoparticles (NO-nps). Tis review summarizes the bioavailability of NO in COVID-19 patients and highlights in vivo and in vitro studies as well as clinical trials with NO administered as a nasal spray, inhalant, or via nanodelivery for therapeutic applications for COVID-19 and other respiratory infections in the future.
Conflicts of Interest Te authors declare no conficts of interest.
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NO has been previously utilized in the management of SARS‐CoV and has shown a similar antiviral effect with SARS‐CoV‐2 in vivo and in vitro. Effective therapy with NO can be used to target several stages of COVID‐19 infection to prevent transmission and progression of the disease. The unique properties of NO allow this simple, gaseous molecule to be administered in various forms. NO can be used as an inhalant, in the form of NO donor drugs such as S‐nitrosothiols and more recently as NO‐releasing nanoparticles (NO‐nps). 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