Pregnant women with COVID-19 can be treated with nitric oxide gas - study

Patients receiving inhaled nitric oxide had an approximately 60% shorter stay in the Intensive Care Unit and about a 64% shorter total hospitalization.

 AN ULTRASOUND examination for a pregnant woman at a gynecology clinic in Tel Aviv. (photo credit: CHEN LEOPOLD/FLASH90)
AN ULTRASOUND examination for a pregnant woman at a gynecology clinic in Tel Aviv.
(photo credit: CHEN LEOPOLD/FLASH90)

High doses of inhaled nitric oxide (iNO) could be used to treat pregnant women who are hospitalized with severe COVID-19 pneumonia, a new study has revealed.

Published in the peer-reviewed journal Obstetrics & Gynecology, the study found that if a patient is heavily monitored during treatment, iNO is an effective treatment to wean pregnant women off of supplemental oxygen faster and therefore reduce the length of their stay at the hospital.

This, in turn, can clear up beds faster, which is particularly important as Israel is facing the sixth wave of the coronavirus pandemic and hospital beds are quickly filling up.  It also significantly reduces the high risk posed to pregnant women, who are four times more likely to die from coronavirus than non-pregnant women, according to lead author Carlo Valsecchi, MD. “They also face a greater risk of obstetric complications such as preeclampsia, preterm delivery, and stillbirth,” he said. 

By the numbers

Of the 71 pregnant patients monitored between March 2020 and December 2021, some 51 were treated with the standard of care only (oxygen supplement, etc.) and 20 were treated with the standard of care plus 30-minute sessions twice daily of iNO.

According to the researchers who conducted the study from four Boston hospitals and led by Massachusetts General Hospital, the iNO treatment gets patients out quicker while causing no side effects.

A doctor examines a pregnant woman at a hospital in the province of Fayoum (credit: REUTERS)A doctor examines a pregnant woman at a hospital in the province of Fayoum (credit: REUTERS)

Patients receiving iNO needed approximately 63% less oxygen supplementation, had an approximate 60% shorter stay at the Intensive Care Unit and about a 64% shorter hospitalization altogether.

"To date, very few respiratory treatments to complement supplemental oxygenation in COVID-19 pregnant patients have been tested," according to senior author Lorenzo Berra, MD.

“Investigators from all four medical centers that participated in our study agreed that administration of high-dose nitric oxide through a snug-fitting mask has enormous potential as a new therapeutic strategy for pregnant patients with COVID-19,” he said.

"Administration of high-dose nitric oxide through a snug-fitting mask has enormous potential as a new therapeutic strategy for pregnant patients with COVID-19"

Senior author Lorenzo Berra, MD

The data analyses within the study "accounted for age, body mass index, gestational age, use of steroids, remdesivir and the study center."

What is nitric oxide treatment?

Nitric oxide was initially approved by the FDA in 1999 as a therapeutic gas treatment for "mechanically ventilated newborns with hypoxic respiratory failure," according to Massachusetts General. 

“Above all, our study supports the safety of high dose nitric oxide in the pregnant population, and we hope more physicians will consider incorporating it into carefully monitored treatment regimens,” Berra said.