OBJECTIVE: 

To evaluate whether the use of inhaled nitric oxide (iNO)₂₀₀ improves respiratory function.

METHODS: 

This retrospective cohort study used data from pregnant patients hospitalized with severe bilateral coronavirus disease 2019 (COVID-19) pneumonia at four teaching hospitals between March 2020 and December 2021. Two cohorts were identified: 1) those receiving standard of care alone (SoC cohort) and 2) those receiving iNO₂₀₀ for 30 minutes twice daily in addition to standard of care alone (iNO₂₀₀ cohort). Inhaled nitric oxide, as a novel therapy, was offered only at one hospital. The prespecified primary outcome was days free from any oxygen supplementation at 28 days postadmission. Secondary outcomes were hospital length of stay, rate of intubation, and intensive care unit (ICU) length of stay. The multivariable-adjusted regression analyses accounted for age, body mass index, gestational age, use of steroids, remdesivir, and the study center.

RESULTS: 

Seventy-one pregnant patients were hospitalized for severe bilateral COVID-19 pneumonia: 51 in the SoC cohort and 20 in the iNO₂₀₀ cohort. Patients receiving iNO₂₀₀ had more oxygen supplementation–free days (iNO₂₀₀: median [interquartile range], 24 [23–26] days vs standard of care alone: 22 [14–24] days, P=.01) compared with patients in the SoC cohort. In the multivariable-adjusted analyses, iNO₂₀₀ was associated with 63.2% (95% CI 36.2–95.4%; P<.001) more days free from oxygen supplementation, 59.7% (95% CI 56.0–63.2%; P<.001) shorter ICU length of stay, and 63.6% (95% CI 55.1–70.8%; P<.001) shorter hospital length of stay. No iNO₂₀₀-related adverse events were reported.

CONCLUSION: 

In pregnant patients with severe bilateral COVID-19 pneumonia, iNO₂₀₀ was associated with a reduced need for oxygen supplementation and shorter hospital stay.

中文翻译：

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高剂量吸入一氧化氮治疗患有 2019 年冠状病毒病 (COVID-19) 肺炎的自主呼吸孕妇

客观的： 

评估使用吸入一氧化氮 (iNO) ₂₀₀是否可以改善呼吸功能。

方法： 

这项回顾性队列研究使用了 2020 年 3 月至 2021 年 12 月期间在四家教学医院因严重双侧冠状病毒病 (COVID-19) 肺炎住院的孕妇的数据。确定了两个队列：1) 仅接受标准护理的患者（SoC 队列） 2)除单独标准护理外，每天两次接受 iNO _{200 30 分钟（每次 30 分钟）的患者（iNO 200}队列）。吸入一氧化氮作为一种新颖的疗法，仅在一家医院提供。预先指定的主要结果是入院后 28 天没有任何氧气补充的天数。次要结局是住院时间、插管率和重症监护室 (ICU) 住院时间。多变量调整回归分析考虑了年龄、体重指数、孕龄、类固醇的使用、瑞德西韦和研究中心。

结果： 

71 名孕妇因严重双侧 COVID-19 肺炎住院：SoC 队列中有 51 人，iNO ₂₀₀队列中有 20 人。与接受 iNO ₂₀₀治疗的患者相比，接受 iNO 200 治疗的患者无需补氧的天数更长（iNO ₂₀₀：中位数[四分位距]，24 [23–26] 天，而仅接受标准护理：22 [14–24] 天，P =.01）在 SoC 队列中。在多变量调整分析中，iNO ₂₀₀与 63.2% (95% CI 36.2–95.4%; P <.001) 无需补充氧气的天数相关，59.7% (95% CI 56.0–63.2%; P <.001 ) ) ICU 住院时间缩短，住院时间缩短63.6% (95% CI 55.1–70.8%; P <.001)。无iNO报告了_{200起相关不良事件。}

结论： 

在患有严重双侧 COVID-19 肺炎的孕妇中，iNO ₂₀₀与补氧需求减少和住院时间缩短有关。