High-dose inhaled nitric oxide (iNO₂₀₀) is associated with a reduced need for oxygen supplementation and shorter hospital stay among pregnant patients with severe bilateral COVID-19 pneumonia, according to a study published online July 7 in Obstetrics & Gynecology.

Carlo Valsecchi, M.D., from Massachusetts General Hospital in Boston, and colleagues conducted a retrospective cohort study using data from pregnant patients hospitalized with severe bilateral COVID-19 pneumonia at four teaching hospitals between March 2020 and December 2021. Two cohorts were identified: 51 patients receiving standard of care alone (SoC cohort) and 20 receiving iNO₂₀₀ for 30 minutes twice daily in addition to SoC (iNO₂₀₀ cohort).

The researchers found that compared with patients in the SoC cohort, those in the iNO₂₀₀ cohort had more oxygen supplementation-free days at 28 days postadmission (median, 24 versus 22 days). iNO₂₀₀ was associated with 63.2 percent more days free from oxygen supplementation and 59.7 and 63.6 percent shorter intensive care unit length of stay and hospital length of stay, respectively, in multivariate analyses. There were no adverse events reported with iNO₂₀₀.

“Based on our present findings and the absence of therapeutic trials in pregnant patients with severe pneumonia, randomized controlled trials are warranted to test improved outcomes with iNO₂₀₀,” the authors write.

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