Evidence map›Paper›PMID 40874173›Full record

ArticleERJ open research2025

Inhaled nitric oxide for the treatment of COVID-19: an open-label, parallel, randomised controlled trial.

Frederico Friedrich, Marcelo Cypel, Vinicius Schenk Michaelsen, Marcos Otávio Antunes Brum, Fabiano Ramos, Roberta Marco, Gustavo Chatkin, Lucas Kich Grun, Letícya Simone Melo Dos Santos, Amanda Paz Santos and 10 more

Abstract read
In one paragraph

Article in ERJ open research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Therapeutic Gases in Biomedicine: Updates on Nitric Oxide and Beyond.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026
    Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Frederico FriedrichCentro Infant, Department of Pediatrics, School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.
Marcelo CypelLatner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada.
Vinicius Schenk MichaelsenLatner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada.
Marcos Otávio Antunes BrumCentro Infant, Department of Pediatrics, School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.
Fabiano RamosHospital São Lucas PUCRS, Porto Alegre, Brazil.
Roberta MarcoHospital São Lucas PUCRS, Porto Alegre, Brazil.
Gustavo ChatkinSchool of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.
Lucas Kich GrunCentro Infant, Department of Pediatrics, School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.
Letícya Simone Melo Dos SantosSchool of Sciences, Health and Life, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.
Amanda Paz SantosCentro Infant, Department of Pediatrics, School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.
Morgana Thaís Carollo FernandesCentro Infant, Department of Pediatrics, School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.
Luciana Medeiros PaungartnerCentro Infant, Department of Pediatrics, School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.
Marcelo Scheffer MaranghelloCentro Infant, Department of Pediatrics, School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.
Caroline LantmannCentro Infant, Department of Pediatrics, School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.
Gustavo EggersCentro Infant, Department of Pediatrics, School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.
Gustavo Duenhas SanchesHospital São Lucas PUCRS, Porto Alegre, Brazil.
Daniel MarinowicSchool of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.ORCID https://orcid.org/0000-0002-1146-0745
Regis Goulart RosaHospital Moinhos de Vento, Porto Alegre, Brazil.
Florencia María Barbé-TuanaSchool of Sciences, Health and Life, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.
Marcus Herbert JonesCentro Infant, Department of Pediatrics, School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Inhaled nitric oxide (iNO) in high concentration inhibits SARS-CoV-2 replication in epithelial cells and may prevent severe disease in hospitalised patients. The aim of this study was to evaluate safety and efficacy of iNO 160 ppm on supplemental oxygen in patients hospitalised with COVID-19. Methods: We conducted an open-label, randomised clinical trial in hospitalised patients with COVID-19 receiving supplemental oxygen. Patients were randomly assigned to receive iNO for 6 h in addition to standard of care. The primary safety end-point was assessed by incidence of adverse events. The secondary efficacy end-point was the number of days free of supplemental oxygen within 15 days after randomisation. Results: 55 patients were enrolled, 27 in the iNO group and 27 in the control group, and one patient was excluded. No adverse events occurred with the inhalation of nitric oxide. Median (IQR) number of days free of supplemental oxygen was 11 (8.0-13.0) in the iNO group and 8 (2.5-10.5) in the control group (p=0.044). The iNO group had a shorter length of hospital stay (4.5 days (3.0-6.3) compared to 7.0 days (6.0-10.0) in the control group; p=0.004). Clinical score was lower in the iNO group on days 3 and 5 (p=0.010 and p=0.033). The number of patients weaned from ventilatory support on day 3 was higher in the iNO group (n=9 (33%)) when compared to controls (n=1 (4%)); p=0.005. Respiratory failure and mortality did not differ between the groups. Conclusion: The iNO treatment was well tolerated and safe. Among adults hospitalised for COVID-19, iNO 160 ppm for 6 h increased the number of days free from supplemental oxygen, shortened the days of ventilatory support and the length of hospital stay, and improved the clinical score.

Identifiers

PMID40874173
PMCPMC12378598

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