Use of inhaled nitric oxide in COVID-19

Inhaled nitric oxide (iNO) is being considered as a potential therapeutic intervention for COVID-19 and post-COVID syndrome due to its various mechanisms such as vasodilation, antiviral activity, antithrombotic and anti-inflammatory effects. There is currently a lack of information on patient selection criteria, optimal dosing, duration and timing of administration, and methods of administration. These factors are of substantial importance for the efficacy of iNO therapy.Aim. To discuss the physiological basis of using inhaled nitric oxide for treating patients with COVID-19 and post-COVID syndrome, analyze the research findings, and present the achievements in nitric oxide synthesis technology in medicine.Conclusion. The early initiation and use of high-dose iNO appears to be an effective and safe treatment strategy for patients with COVID-19, as it targets the basic pathological mechanisms of the disease. iNO may also be a promising therapeutic option for patients with post-COVID syndrome. However, the optimal dosing regimen, continuous or intermittent, warrants further investigation. Recent advances in nitric oxide synthesis technology are of great significance for the broad practical application of iNO therapy.