Inhaled Nitric Oxide Shown to Help Pregnant Women with Severe Coronavirus, MGH Study Finds | Virus World | Scoop.it
From www.bostonherald.com - September 3, 2020 9:05 PM

Pregnant women with severe and critical COVID-19 had rapid improvement in their heart and lung function along with decreased inflammation when given inhaled nitric oxide gas, a new Massachusetts General Hospital study shows.  “We noted rapid relief from breathlessness in these patients, with lower respiratory rate and better oxygenation after mask administration of high concentration nitric oxide, with no adverse side effects,” said Dr. Lorenzo Berra, investigator in the department of anesthesia, critical care and pain medicine at MGH. Nitric oxide, known for saving the lives of oxygen-starved newborns, was given to six pregnant coronavirus patients at MGH at a high dosage for 30-60 minutes, twice a day, for a total of 39 treatments.  The patients were severe — all six needed supplemental oxygen, four were treated in the ICU and two were intubated, according to the study in Obstetrics & Gynecology.

 
Improvement in heart and lung function was observed after starting the nitric oxide gas and oxygen levels increased during each treatment. No adverse side effects were reported by the patients. In addition to the improved heart and lung function, inflammation decreased and the viral infection was gone in five of the six patients after 22 days, the study shows. Five of the patients did not take any antiviral medication and yet were clear of the virus, meaning nitric oxide could have antiviral properties, but more studies are needed to confirm it. “All patients were discharged in stable condition from the hospital. We found these results to be very encouraging,” said Berra. Three of the six women delivered four babies, including a set of twins, while in the hospital, and each infant tested negative for COVID-19 and remained in good health 28 days after the mother was admitted to the hospital. Nitric oxide works by increasing oxygen levels by opening constricted blood vessels, especially in more well-ventilated areas of the lung. A recent report from the Centers for Disease Control and Prevention suggests that pregnant women with the coronavirus are more likely to be hospitalized, are at increased risk of being admitted to the intensive care unit and require mechanical ventilation more often than other women.
 

The MGH study is the first to investigate the role of inhaled nitric oxide in pregnant people with COVID-19. Massachusetts General Hospital was also the first in the nation to test nitric oxide for COVID-19 treatment in other patients too. That study tests inhaled nitric oxide in patients with mild to moderate cases of the coronavirus and is delivered through a CPAP breathing machine for 20-30 minutes twice a day for two weeks. Yet another trial at MGH is for the prevention of the coronavirus in health care providers working with infected patients. Under that study, staff would inhale a high dose of the drug for 10 to 15 minutes at the start and end of every shift. The study would then look see the percentage of subjects in each group with a positive test during the 14-day study period.

Published in Obstetrics & Gynecology (August 26, 2020):

https://doi.org/10.1097/AOG.0000000000004128