Ghosh Arunibha, Joseph Betsy, Anil Sukumaran
Neurosciences, S.N.Pradhan Centre for Neurosciences, University of Calcutta, Kolkata, IND.
Periodontics, Saveetha University, Chennai, IND.
Cureus. 2022 Apr 5;14(4):e23852. doi: 10.7759/cureus.23852. eCollection 2022 Apr.
The severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2) virus causing COVID-19 significantly affects the respiratory functions of infected individuals by massively disrupting the pulmonary oxygenation and activating the synthesis of proinflammatory cytokines, inducing severe oxidative stress, enhanced vascular permeability, and endothelial dysfunction which have rendered researchers and clinicians to depend on prophylactic treatment due to the unavailability of proper disease management approaches. Previous studies have indicated that nitric oxide (NO) application appears to be significant concerning the antiviral activities, antioxidant, and anti-inflammatory properties in relieving disease-related symptoms. To identify, explore, and map the literature on the role of nitric oxide in the management of respiratory consequences in COVID-19 through this scoping review, Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed during the search to answer the focal question: "What are the potential uses of nitric oxide in the management of respiratory failure in COVID-19?" Administering exogenous NO in the form of inhaled gas or stimulating the system to produce NO appears to be a suitable option to manage COVID-19-induced pneumonia and respiratory illness. This treatment modality seems to attenuate respiratory distress among patients suffering from severe infections or patients with comorbidities. Exogenous NO at different doses effectively reduces systemic hyperinflammation and oxidative stress, improves arterial oxygenation, and restores pulmonary alveolar cellular integrity to prevent the lungs and other organs from further damage. This therapy could pave the way for better management of COVID-19 before the onset of disease-related complications.
导致新冠肺炎的严重急性呼吸综合征冠状病毒2（SARS-CoV-2）通过大规模破坏肺氧合作用并激活促炎细胞因子的合成，显著影响受感染个体的呼吸功能，引发严重的氧化应激、血管通透性增加和内皮功能障碍，由于缺乏适当的疾病管理方法，这使得研究人员和临床医生依赖预防性治疗。先前的研究表明，一氧化氮（NO）的应用在抗病毒活性、抗氧化和抗炎特性以缓解疾病相关症状方面似乎具有重要意义。为了通过本范围综述确定、探索和梳理关于一氧化氮在新冠肺炎呼吸后果管理中作用的文献，在检索过程中遵循了系统评价和Meta分析的首选报告项目（PRISMA）指南，以回答核心问题：“一氧化氮在新冠肺炎呼吸衰竭管理中的潜在用途有哪些？”以吸入气体形式给予外源性一氧化氮或刺激系统产生一氧化氮似乎是管理新冠肺炎诱发的肺炎和呼吸道疾病的合适选择。这种治疗方式似乎可以减轻重症感染患者或合并症患者的呼吸窘迫。不同剂量的外源性一氧化氮可有效减轻全身炎症反应和氧化应激，改善动脉氧合，并恢复肺泡细胞完整性，以防止肺部和其他器官进一步受损。这种疗法可为在疾病相关并发症出现之前更好地管理新冠肺炎铺平道路。
