Nitric oxide therapy could reduce ventilator use in serious COVID-19 patients

The global reach of the coronavirus has also meant a monumental response to it; countless clinical trials are being conducted to find some sort of therapy or vaccine against it.  

A part of the long list is the gas nitric oxide. Nitric Oxide (NO) is naturally present in the body and helps the blood vessels dilate to assist in the flow of blood and oxygen around the body. It is this ability which has been translated into widespread medical use; it is given to ‘blue babies’ to facilitate blood flow and to cardiac patients and those with pulmonary issues as well. In fact, the ability to dilate blood vessels explains its role in the production of Viagra as well.  

What is its role in assisting with COVID-19 cases?

Severe cases of COVID-19 can cause damage to the lungs and lead to Acute Respiratory Distress Syndrome (ARDS), which makes it difficult to breathe and can lead to complete system failure. Nitric Oxide can relieve vessels blocked by damage and assist in breathing.  

Preliminary studies from China and Italy have shown that administering NO helped patients experiencing respiratory distress. Further studies need to be conducted to understand this - researchers at Massachusetts General Hospital are recruiting patients to set up a controlled study of 240 subjects. To begin with, those with mild to moderate symptoms will be tested in an experimental and control group. Those in the experimental group will inhale the gas through a pump for 30 minutes, two to three times a day. The aim is to see if the gas can prevent the disease from becoming severe and eventually cure the patients.

If the experiment is successful, it can be of huge help from a public health perspective, as those given NO support earlier may not require to be put on ventilator support afterwards.

What do previous studies say?

Previous studies have shown that the gas could have a direct impact on the virus as well. A small study showed that the gas could kill the virus responsible for the SARS outbreak of 2003. Subsequent studies in monkeys concurred with these findings and showed that the gas cut the replication rate of the SARS virus. Since the SARS virus (SARS-CoV-1) and COVID-19 virus (SARS-CoV-2) have many similarities, the researchers are cautiously hopeful about the results.  

However, those were small studies that were not done in humans, so extensive research is required to come to a conclusion.

Some caution and further studies  

The dosage of the gas needs to be carefully monitored since large volumes can hamper the ability of haemoglobin to absorb oxygen. This is quickly resolved if the NO source is removed, but caution needs to be taken to prevent mishaps.  

The researchers are also planning a second experimental trial with healthcare workers. The study aims to understand if NO can be used prophylactically for health workers between work shifts. They will be administered the gas for 10-15 minutes before and after work to mitigate the effects of possible infection. Given that the gas has few side effects and is widely used, this could be a bright development in the fight against the virus.

For more information, read our article on   COVID-19 Prevention and Care Tips for Parents With Young Children _._

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