Saying No to SARS-CoV-2: The Potential of Nitric Oxide in the Treatment of COVID-19 Pneumonia

Nitric oxide (NO) shows potential in treating COVID-19 pneumonia by inhibiting SARS-CoV-2 replication and improving pulmonary symptoms. It can modify viral proteins and inhibit viral entry by S-nitrosylating ACE2. Inhaled NO has shown benefits in small studies, improving oxygenation and reducing pulmonary hypertension, but larger studies are needed to confirm its efficacy. NO's antiplatelet properties may alleviate cardiovascular symptoms, and NO-based therapies, including inhaled NO and NO-releasing solutions, are being explored. However, the effectiveness of NO may be limited by endothelial damage and vascular dysfunction, and potential side effects like lung methemoglobinemia require careful monitoring. Further research is needed to establish NO's therapeutic role in COVID-19.