Pneumonia caused by COVID-19 is particularly threatening to pregnant women because it can quickly progress to a lack of oxygen in the blood and body tissues, a condition known as hypoxemia, which requires hospitalization and cardiopulmonary support. “Compared with non-pregnant female patients with COVID-19, pregnant women are three times more likely to require hospitalization in intensive care, mechanical ventilation or life support, and four times more likely to die.” times,” noted doctor Carlo Valsecchi. lead author in the Department of Anesthesia, Critical Care, and Pain Medicine, MGH. “They also face increased risk of obstetric complications such as pre-eclampsia, preterm birth and stillbirth.”
Nitric oxide is a therapeutic gas first approved by the U.S. Food and Drug Administration in 1999 for the respiratory treatment of intubated and mechanically ventilated infants with respiratory failure due to lack of oxygen. With MGH spurring much of the initial research, iNO at high concentrations has also been shown to be effective as an antibacterial agent in reducing the replication of SARS-CoV-1 and more recently SARS Co- V-2, the virus that causes COVID-19. During the first wave of COVID-19, MGH treated six non-intubated pregnant patients with iNO at high doses up to 200 parts per million (ppm). The findings of a more favorable outcome with iNO led MGH clinicians to recommend this treatment to other pregnant patients and to design the present study to determine safety and efficacy. Effect of iNO200 on COVID-19 pneumonia in pregnancy.
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To that end, a collaborative network of four medical centers in the Boston area was formed. In addition to MGH, it includes Tufts Medical Center, Beth Israel Principal Medical Center, and Boston Medical Center. Researchers and clinicians from multiple departments — including critical care medicine, respiratory care, and fetal medicine — studied 71 pregnant patients with severe COVID-19 pneumonia entering at these hospitals, 20 of whom received iNO200 twice daily. The study showed that iNO therapy at this dose, when compared with standard of care alone, resulted in reduced supplemental oxygen requirements and length of hospital and ICU stay. No intervention-related adverse events were reported in both mothers and their infants.
“Being able to wean patients from respiratory support more quickly could have other profound implications, including reducing stress for women and their families, reducing the risk of infections,” Berra notes. hospital stay and reduce the burden on the health care system,” noted Berra. “Above all, our study supports the safety of high-dose nitric oxide in pregnancy, and we hope more doctors will consider incorporating it into carefully monitored treatment regimens.”
Source: Eurekalert
