Role of Nitric Oxide in COVID-19 Disease Progression

The role of nitric oxide is pivotal in the treatment against SARS-CoV-2, the coronavirus that is responsible for causing COVID-19, as per a study from the George Washington University (GW) published in the peer-reviewed journal Nitric Oxide.

Nitric oxide (NO) is an antimicrobial and anti-inflammatory molecule that is produced naturally in the body. It is responsible for its key roles in pulmonary vascular function with regards to viral infections and other pulmonary diseases. In 2003, the SARS-CoV-1 infection led to the outbreak of SARS (severe acute respiratory syndrome), wherein nitric oxide prevented viral replication by cytotoxic reactions through intermediaries such as peroxynitrite. It is regarded as one of the few potential treatments for COVID-19 included in the U.S. FDA’s emergency expanded access program.

Adam Friedman, MD, interim chair and professor in the Department of Dermatology at the GW School of Medicine and Health Sciences, who also co-authored the review, said: “Nitric oxide plays crucial roles in maintaining healthy vascular function and managing inflammatory cascades that result in acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). Interventions play a significant role for patients and healthcare systems during the outbreak, that are protective against ALI and ARDS.

Coronaviruses are a large category of RNA viruses that mainly infect birds or livestock, but can prove to be highly infectious and dangerous in humans. At present, there’s no registered treatment or vaccine for COVID-19. The lack of proper vaccine and high death rate of the virus describes the urgent need for therapeutics that may prevent the replication of the virus and help contain it.

The team of researchers — led by Nagasai Adusumilli, MBA, a fourth-year medical student at the GW School of Medicine and Health Sciences — examined data from between 1993 and 2020 on the origin and development of coronaviruses and the use of nitric oxide as a potential treatment for respiratory illness. The team underline the prospective for inhaled nitric oxide leading to better clinical outcomes and easing the rising strain on healthcare capacity due to COVID-19. Mr. Adusumilli is also the first author of the study.

The researchers suggest that if nitric oxide’s potential is demonstrated for COVID-19, its use as a proven treatment can be crucial in the fight against the coronavirus.

For over two decades, Friedman has been partnering with co-senior author Joel Friedman, MD, Ph.D., professor of physiology and biophysics and medicine at Albert Einstein College of Medicine, on the study related to the use of nitric oxide for medical treatments and together are finding therapeutics based on nitric oxide for COVID-19.