Clinical Efficacy of Inhaled Nitric Oxide in Preventing the Progression of Moderate to Severe COVID-19 and Its Correlation to Viral Clearance:Results of a Pilot Study

作     者：Merlin Moni Thushara Madathil Dipu T.Sathyapalan Veena Menon Georg Gutjahr Fabia Edathadathil Deepthi Sureshkumar Preetha Prasanna Soumya Jose Roshni Jerome Ajai Krishnan Indulekha C.L.Pillai Geetha Kumar Bipin Nair Victor Nizet Aveek Jayant Merlin Moni;Thushara Madathil;Dipu T.Sathyapalan;Veena Menon;Georg Gutjahr;Fabia Edathadathil;Deepthi Sureshkumar;Preetha Prasanna;Soumya Jose;Roshni Jerome;Ajai Krishnan;Indulekha C.L.Pillai;Geetha Kumar;Bipin Nair;Victor Nizet;Aveek Jayant

作者机构：Department of MedicineDivision of Infectious DiseasesAmrita Institute of Medical ScienceAmrita Vishwa VidyapeethamKochiKeralaIndia Department of Cardiac AnaesthesiologyAmrita Institute of Medical ScienceAmrita Vishwa VidyapeethamKochiKeralaIndia Clinical Virology LaboratoryAmrita Institute of Medical SciencesAmrita Vishwa VidyapeethamKochiKeralaIndia Center for Research in Analytics and Technologies for Education(CREATE)Amrita Vishwa VidyapeethamAmritapuriKollamKeralaIndia Department of Infection Control and EpidemiologyAmrita Institute of Medical ScienceAmrita Vishwa VidyapeethamKochiKeralaIndia School of MedicineAmrita Institute of Medical ScienceAmrita Vishwa VidyapeethamKochiKeralaIndia School of BiotechnologyAmrita Vishwa VidyapeethamAmritapuriKollamKeralaIndia Skaggs School of Pharmacy and Pharmaceutical SciencesUniversity of CaliforniaSan DiegoLa JollaCaliforniaUSA Department of PediatricsUniversity of CaliforniaSan DiegoLa JollaCaliforniaUSA 

出 版 物：《Infectious Microbes & Diseases》 (感染微生物与疾病（英文）)

年 卷 期：2022年第4卷第1期

页      面：26-33页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：The trial was investigator-initiated and institutionally funded with intramural research grants from the Amrita Institute of Medical Sciences and the Amrita School of Biotechnology 

主　　题：nitric oxide COVID-19 antiviral activity WHO ordinal scale 

摘      要：Hypoxic patients with coronavirus disease 2019(COVID-19)are at high risk of adverse *** nitric oxide(iNO)has shown anti-viral and immunomodulatory effects in ***,in vivo evidence of efficacy in hypoxic COVID-19 is *** open label feasibility study was conducted at a single referral center in South India and evaluated the effectiveness of repurposed iNO in improving clinical outcomes in COVID-19 and its correlation with viral *** recruited hypoxemic COVID-19 patients and allocated them into treatment(iNO)and control groups(1:1).Viral clearance on day 5 favored the treatment group(100%vs 72%,P0.01).The speed of viral clearance as adjudged by normalized longitudinal cycle threshold(Ct)values was positively impacted in the treatment *** proportion of patients who attained clinical improvement,defined as a≥2-point change on the World Health Organization ordinal scale,was higher in the iNO cohort(n=11,79%)as compared to the control group(n=4,36%)(odds ratio 6.42,95%confidence interval 1.09–37.73,P=0.032).The proportion of patients progressing to mechanical ventilation in the control group(4/11)was significantly higher than in the treatment group(0/14).The all-cause 28-day mortality was significantly different among the study arms,with 36%(4/11)of the patients dying in the control group while none died in the treatment *** numbers needed to treat to prevent an additional poor outcome of death was estimated to be *** study demonstrates the putative role of repurposed iNO in hypoxemic COVID-19 patients and calls for extended validation.