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1.
Medicina (Kaunas) ; 57(12)2021 Nov 30.
Article in English | MEDLINE | ID: covidwho-1598246

ABSTRACT

Background and Objectives: This study aimed to assess the effect of neck stabilization exercise on respiratory function in stroke patients through longitudinal observation and determine whether there is a difference in its effect based on the side of paralysis in the patients. It is difficult to observe the amount of change observed in individuals and groups as most intergroup comparison studies only use mean values. To address these shortcomings, this study adopted a hierarchical linear model (HLM) in our trajectory analysis. Materials and Methods: We conducted neck stabilization training three times a week for four weeks in a single group of 21 stroke patients. To evaluate respiratory function, their forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), forced expiration ratio (FEV1/FVC), and peak cough flow (PCF) were measured. Data analysis was performed using HLM 8.0. Results: A significant increase was found in the respiratory function after neck stabilization training (p < 0.05). While neck stabilization training overall was longitudinally effective, the growth rate of respiratory function in left-sided paralytic patients was less than the whole group value. Conversely, the growth rate of respiratory function in right-sided paralytic patients was greater than the whole group value. Conclusions: This study demonstrated that neck stabilization training is longitudinally effective in improving respiratory function in stroke patients. Additionally, the growth rate of respiratory function was greater in patients with right side paralysis than in patients with left side paralysis.


Subject(s)
Respiratory Muscles , Stroke , Exercise Therapy , Humans , Linear Models , Respiration , Stroke/complications
2.
Am J Respir Crit Care Med ; 204(9): 1011-1013, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1526563
3.
Sci Rep ; 11(1): 12110, 2021 06 08.
Article in English | MEDLINE | ID: covidwho-1517640

ABSTRACT

Wearing surgical masks or other similar face coverings can reduce the emission of expiratory particles produced via breathing, talking, coughing, or sneezing. Although it is well established that some fraction of the expiratory airflow leaks around the edges of the mask, it is unclear how these leakage airflows affect the overall efficiency with which masks block emission of expiratory aerosol particles. Here, we show experimentally that the aerosol particle concentrations in the leakage airflows around a surgical mask are reduced compared to no mask wearing, with the magnitude of reduction dependent on the direction of escape (out the top, the sides, or the bottom). Because the actual leakage flowrate in each direction is difficult to measure, we use a Monte Carlo approach to estimate flow-corrected particle emission rates for particles having diameters in the range 0.5-20 µm. in all orientations. From these, we derive a flow-weighted overall number-based particle removal efficiency for the mask. The overall mask efficiency, accounting both for air that passes through the mask and for leakage flows, is reduced compared to the through-mask filtration efficiency, from 93 to 70% for talking, but from only 94-90% for coughing. These results demonstrate that leakage flows due to imperfect sealing do decrease mask efficiencies for reducing emission of expiratory particles, but even with such leakage surgical masks provide substantial control.


Subject(s)
Aerosols , Communicable Disease Control/methods , Cough , Exhalation , Filtration , Masks , Virus Diseases/prevention & control , Adolescent , Adult , COVID-19/prevention & control , Equipment Failure , Female , Humans , Male , Middle Aged , Monte Carlo Method , Particle Size , Probability , Respiration , Sneezing , Young Adult
4.
PLoS One ; 16(11): e0257549, 2021.
Article in English | MEDLINE | ID: covidwho-1511814

ABSTRACT

Particulate generation occurs during exercise-induced exhalation, and research on this topic is scarce. Moreover, infection-control measures are inadequately implemented to avoid particulate generation. A laminar airflow ventilation system (LFVS) was developed to remove respiratory droplets released during treadmill exercise. This study aimed to investigate the relationship between the number of aerosols during training on a treadmill and exercise intensity and to elucidate the effect of the LFVS on aerosol removal during anaerobic exercise. In this single-center observational study, the exercise tests were performed on a treadmill at Running Science Lab in Japan on 20 healthy subjects (age: 29±12 years, men: 80%). The subjects had a broad spectrum of aerobic capacities and fitness levels, including athletes, and had no comorbidities. All of them received no medication. The exercise intensity was increased by 1-km/h increments until the heart rate reached 85% of the expected maximum rate and then maintained for 10 min. The first 10 subjects were analyzed to examine whether exercise increased the concentration of airborne particulates in the exhaled air. For the remaining 10 subjects, the LFVS was activated during constant-load exercise to compare the number of respiratory droplets before and after LFVS use. During exercise, a steady amount of particulates before the lactate threshold (LT) was followed by a significant and gradual increase in respiratory droplets after the LT, particularly during anaerobic exercise. Furthermore, respiratory droplets ≥0.3 µm significantly decreased after using LFVS (2120800±759700 vs. 560 ± 170, p<0.001). The amount of respiratory droplets significantly increased after LT. The LFVS enabled a significant decrease in respiratory droplets during anaerobic exercise in healthy subjects. This study's findings will aid in exercising safely during this pandemic.


Subject(s)
Air Conditioning/methods , COVID-19/prevention & control , Exercise/physiology , Particulate Matter/chemistry , Adult , Aerosols/chemistry , Air Filters , Anaerobic Threshold/physiology , COVID-19/metabolism , Exercise Test/methods , Exhalation/physiology , Female , Heart Rate/physiology , Humans , Japan , Lactic Acid/metabolism , Male , Oxygen Consumption/physiology , Respiration , Respiratory System/physiopathology , Running/physiology , SARS-CoV-2/pathogenicity , Ventilation/methods
5.
Sci Rep ; 11(1): 21807, 2021 11 08.
Article in English | MEDLINE | ID: covidwho-1506761

ABSTRACT

In this study, we compare the predictive value of clinical scoring systems that are already in use in patients with Coronavirus disease 2019 (COVID-19), including the Brescia-COVID Respiratory Severity Scale (BCRSS), Quick SOFA (qSOFA), Sequential Organ Failure Assessment (SOFA), Multilobular infiltration, hypo-Lymphocytosis, Bacterial coinfection, Smoking history, hyper-Tension, and Age (MuLBSTA) and scoring system for reactive hemophagocytic syndrome (HScore), for determining the severity of the disease. Our aim in this study is to determine which scoring system is most useful in determining disease severity and to guide clinicians. We classified the patients into two groups according to the stage of the disease (severe and non-severe) and adopted interim guidance of the World Health Organization. Severe cases were divided into a group of surviving patients and a deceased group according to the prognosis. According to admission values, the BCRSS, qSOFA, SOFA, MuLBSTA, and HScore were evaluated at admission using the worst parameters available in the first 24 h. Of the 417 patients included in our study, 46 (11%) were in the severe group, while 371 (89%) were in the non-severe group. Of these 417 patients, 230 (55.2%) were men. The median (IQR) age of all patients was 44 (25) years. In multivariate logistic regression analyses, BRCSS in the highest tertile (HR 6.1, 95% CI 2.105-17.674, p = 0.001) was determined as an independent predictor of severe disease in cases of COVID-19. In multivariate analyses, qSOFA was also found to be an independent predictor of severe COVID-19 (HR 4.757, 95% CI 1.438-15.730, p = 0.011). The area under the curve (AUC) of the BRCSS, qSOFA, SOFA, MuLBSTA, and HScore was 0.977, 0.961, 0.958, 0.860, and 0.698, respectively. Calculation of the BRCSS and qSOFA at the time of hospital admission can predict critical clinical outcomes in patients with COVID-19, and their predictive value is superior to that of HScore, MuLBSTA, and SOFA. Our prediction is that early interventions for high-risk patients, with early identification of high-risk group using BRCSS and qSOFA, may improve clinical outcomes in COVID-19.


Subject(s)
COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/immunology , Adult , Aged , Area Under Curve , Coinfection/diagnosis , Female , Hospital Mortality , Humans , Intensive Care Units , Lymphocytosis , Male , Middle Aged , Observer Variation , Organ Dysfunction Scores , Patient Admission , Predictive Value of Tests , Prognosis , Regression Analysis , Respiration , Respiration Disorders , Risk Factors , SARS-CoV-2 , Severity of Illness Index , Smoking , Treatment Outcome
7.
Comput Biol Med ; 138: 104944, 2021 11.
Article in English | MEDLINE | ID: covidwho-1466249

ABSTRACT

COVID-19 heavily affects breathing and voice and causes symptoms that make patients' voices distinctive, creating recognizable audio signatures. Initial studies have already suggested the potential of using voice as a screening solution. In this article we present a dataset of voice, cough and breathing audio recordings collected from individuals infected by SARS-CoV-2 virus, as well as non-infected subjects via large scale crowdsourced campaign. We describe preliminary results for detection of COVID-19 from cough patterns using standard acoustic features sets, wavelet scattering features and deep audio embeddings extracted from low-level feature representations (VGGish and OpenL3). Our models achieve accuracy of 88.52%, sensitivity of 88.75% and specificity of 90.87%, confirming the applicability of audio signatures to identify COVID-19 symptoms. We furthermore provide an in-depth analysis of the most informative acoustic features and try to elucidate the mechanisms that alter the acoustic characteristics of coughs of people with COVID-19.


Subject(s)
COVID-19 , Voice , Cough/diagnosis , Humans , Respiration , SARS-CoV-2
8.
Obstet Gynecol ; 138(4): 616-621, 2021 10 01.
Article in English | MEDLINE | ID: covidwho-1462518

ABSTRACT

OBJECTIVE: To characterize respiratory emissions produced during labor and vaginal delivery vis-à-vis the potential for transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). METHODS: Observational study of three women who tested negative for SARS-CoV-2 and had uncomplicated vaginal deliveries. Using background-oriented schlieren imaging, we evaluated the propagation of respiratory emissions produced during the labor course and delivery. The primary outcome was the speed and propagation of breath over time, calculated through processed images collected throughout labor and delivery. RESULTS: In early labor with regular breathing, the speed of the breath was 1.37 meters/s (range 1.20-1.55 meters/s). The breath appeared to propagate faster with a cough during early labor at a speed of 1.69 meters/s (range 1.22-2.27 meters/s). During the second stage of labor with Valsalva and forced expiration, the propagation speed was 1.79 meters/s (range 1.71-1.86 meters/s). CONCLUSION: Labor and vaginal delivery increase the propagation of respiratory emissions that may increase risk of respiratory transmission of SARS-CoV-2.


Subject(s)
Air Microbiology , COVID-19/transmission , Inhalation Exposure/analysis , Labor, Obstetric/physiology , Respiration , Adult , Delivery, Obstetric/methods , Disease Transmission, Infectious , Female , Humans , Pregnancy , SARS-CoV-2 , Vagina , Young Adult
9.
BMJ Open Respir Res ; 8(1)2021 10.
Article in English | MEDLINE | ID: covidwho-1462982

ABSTRACT

INTRODUCTION: COVID-19 pandemic has had a huge impact on global health to date, with 5.6 million cases in the UK since its emergence. The respiratory symptoms largely mimic those of pneumonia' with symptoms ranging from mild to severe. The effects on respiratory physiology are not yet fully understood, but evidence is emerging that there is much dysfunctional breathing reported but little information on tidal ventilation from the acute phase of the infection. Structured light plethysmography (SLP) is a contactless technique of respiratory function testing that measures tidal breathing parameters by assessing thoracoabdominal displacement. METHODS: In a postdischarge clinic, SLP was performed routinely on 110 hospitalised patients recovering from COVID-19 who had been screened for respiratory symptoms to confirm any respiratory changes occurring after the disease. Patients were categorised based on their hospital treatment in (1) the intensive therapy unit (ITU) (requiring intubation) (n=65) or (2) respiratory wards only (n=45). Data from these two patient cohorts were compared with preacquired data from healthy controls (n=30). RESULTS: We have found a significantly increased respiratory rate (p=0.006) in ITU patients compared with the healthy cohort and also a significant decrease in the inspiratory time (p=0.01), expiratory time (p=0.005) and the total breathing cycle (p=0.008). There were no significant differences between ITU and ward patients and no significant differences in healthy compared with ward patients. We examined the variability of breathing ('entropy') both in terms of the breath-to-breath interval and the volume-to-volume change. The breath-to-breath interval alone was significantly lower in ITU patients compared with healthy cohorts (p=0.02). CONCLUSION: Our findings suggest that abnormalities in tidal breathing can be detected in COVID-19 recovery patients, and SLP may be a promising tool in assessing the aftermath of diseases such as COVID-19, particularly if more intensive management strategies such as mechanical ventilation are required.


Subject(s)
COVID-19 , Aftercare , Humans , Pandemics , Patient Discharge , Plethysmography , Respiration , SARS-CoV-2
10.
Curr Top Microbiol Immunol ; 426: 21-43, 2020.
Article in English | MEDLINE | ID: covidwho-1451909

ABSTRACT

Pulmonary respiration inevitably exposes the mucosal surface of the lung to potentially noxious stimuli, including pathogens, allergens, and particulates, each of which can trigger pulmonary damage and inflammation. As inflammation resolves, B and T lymphocytes often aggregate around large bronchi to form inducible Bronchus-Associated Lymphoid Tissue (iBALT). iBALT formation can be initiated by a diverse array of molecular pathways that converge on the activation and differentiation of chemokine-expressing stromal cells that serve as the scaffolding for iBALT and facilitate the recruitment, retention, and organization of leukocytes. Like conventional lymphoid organs, iBALT recruits naïve lymphocytes from the blood, exposes them to local antigens, in this case from the airways, and supports their activation and differentiation into effector cells. The activity of iBALT is demonstrably beneficial for the clearance of respiratory pathogens; however, it is less clear whether it dampens or exacerbates inflammatory responses to non-infectious agents. Here, we review the evidence regarding the role of iBALT in pulmonary immunity and propose that the final outcome depends on the context of the disease.


Subject(s)
Bronchi/immunology , Immunity, Mucosal/immunology , Respiration/immunology , Humans , Lymphocytes/immunology
11.
J Acoust Soc Am ; 150(3): 2030, 2021 09.
Article in English | MEDLINE | ID: covidwho-1438063

ABSTRACT

Both the scarcity and environmental impact of disposable face masks, as in the COVID-19 pandemic, have instigated the recent development of reusable masks. Such face masks reduce transmission of infectious agents and particulates, but often impact a user's ability to be understood when materials, such as silicone or hard polymers, are used. In this work, we present a numerical optimisation approach to optimise waveguide topology, where a waveguide is used to transmit and direct sound from the interior of the mask volume to the outside air. This approach allows acoustic energy to be maximised according to specific frequency bands, including those most relevant to human speech. We employ this method to convert a resuscitator mask, made of silicone, into respiration personal protective equipment (PPE) that maximises the speech intelligibility index (SII). We validate this approach experimentally as well, showing improved SII when using the fabricated device. Together, this design represents a unique and effective approach to utilize and adapt available apparatus to filter air while improving the ability to communicate effectively, including in healthcare settings.


Subject(s)
COVID-19 , Speech Intelligibility , Humans , Masks , Pandemics , Respiration , SARS-CoV-2
12.
Comput Biol Med ; 138: 104858, 2021 11.
Article in English | MEDLINE | ID: covidwho-1400212

ABSTRACT

This study presents a series of numerical simulations for airflow field and particle dispersion and deposition around a mannequin inside a ventilated room. A 3-D airway system of a volunteer subject with a large respiratory system was reconstructed from the nostril inlet to the end of the tracheobronchial tree 4th generation and was integrated into a standing mannequin at the center of a room. The room ventilation system supplied air through a diffuser and expelled air via a damper in three modes. The airflow field was first evaluated by solving the governing equations and the k-ω SST transitional turbulence model using the Ansys-Fluent software. Then spherical particles with various diameters were released into the room, and their trajectories were evaluated using the Lagrangian approach. Aspiration fraction and particle deposition for inhalation flow rates of 15 and 30 L/min were analyzed using a modified discrete random walk (DRW) stochastic model using a user-defined function (UDF) coupled to the Ansys-Fluent discrete phase model. For the first ventilation mode, a recirculation flow region formed behind the mannequin that led the airflow streamlines to the breathing zone. A recirculation flow formed in front of the face for the second ventilation mode that led the airflow streamlines out of the mannequin breathing zone. For the third mode, however, there was no strong recirculation flow zone around the mannequin. Simulation results showed that the aspiration fraction in the first ventilation mode was higher than the other modes. In addition, the regional deposition rates and deposition patterns of particles inside the respiratory system were presented for each region. Accordingly, most large particles were trapped in the nasal passage; however, some large particles penetrated deeper into the airway due to the large airway size. For the higher breathing rate, the percentage of large escaped particles from the lobe branches dropped by a factor of 7 compared to the lower breathing rate.


Subject(s)
Manikins , Respiration , Bronchi , Computer Simulation , Humans , Particle Size
13.
J Ethnopharmacol ; 280: 114488, 2021 Nov 15.
Article in English | MEDLINE | ID: covidwho-1397458

ABSTRACT

ETHNOPHARMACOLOGICAL RELEVANCE: Traditional Chinese medicine (TCM) has a long history in the prevention and treatment of pandemics. The TCM formula Lung Cleansing and Detoxifying Decoction (LCDD), also known as Qing Fei Pai Du Decoction, has been demonstrated effective against Coronavirus Disease 2019 (COVID-19). AIM OF THE STUDY: This work aimed to elucidate the active ingredients, targets and pathway mechanism of LCDD related to suppression of inflammatory, immunity regulation and relaxation of airway smooth muscle for the treatment of COVID-19. MATERIALS AND METHODS: Mining chemical ingredients reported in LCDD, 144 compounds covering all herbs were selected and screened against inflammatory-, immunity- and respiratory-related GPCRs including GPR35, H1, CB2, B2, M3 and ß2-adrenoceptor receptor using a label-free integrative pharmacology method. Further, all active compounds were detected using liquid chromatography-tandem mass spectrometry, and an herb-compound-target network based on potency and content of compounds was constructed to elucidate the multi-target and synergistic effect. RESULTS: Thirteen compounds were identified as GPR35 agonists, including licochalcone B, isoliquiritigenin, etc. Licochalcone B, isoliquiritigenin and alisol A exhibited bradykinin receptor B2 antagonism activities. Atractyline and shogaol showed as a cannabinoid receptor CB2 agonist and a histamine receptor H1 antagonist, respectively. Tectorigenin and aristofone acted as muscarinic receptor M3 antagonists, while synephrine, ephedrine and pseudoephedrine were ß2-adrenoceptor agonists. Pathway deconvolution assays suggested activation of GPR35 triggered PI3K, MEK, JNK pathways and EGFR transactivation, and the activation of ß2-adrenoceptor mediated MEK and Ca2+. The herb-compound-target network analysis found that some compounds such as licochalcone B acted on multiple targets, and multiple components interacted with the same target such as GPR35, reflecting the synergistic mechanism of Chinese medicine. At the same time, some low-abundance compounds displayed high target activity, meaning its important role in LCDD for anti-COVID-19. CONCLUSIONS: This study elucidates the active ingredients, targets and pathways of LCDD. This is useful for elucidating multitarget synergistic action for its clinical therapeutic efficacy.


Subject(s)
Biosensing Techniques/methods , COVID-19/drug therapy , Drugs, Chinese Herbal/chemistry , Drugs, Chinese Herbal/pharmacology , Animals , Cell Line, Tumor , Chalcones/pharmacology , Cricetulus , Drugs, Chinese Herbal/analysis , Ephedrine/pharmacology , HEK293 Cells , Humans , Immunity/drug effects , Inflammation/metabolism , Lung Diseases/metabolism , Muscle, Smooth/drug effects , Receptors, G-Protein-Coupled/metabolism , Respiration/drug effects , Signal Transduction/drug effects
16.
J Aerosol Med Pulm Drug Deliv ; 33(4): 230-234, 2020 08.
Article in English | MEDLINE | ID: covidwho-1387691

ABSTRACT

Background: The transmission of respiratory viruses such as influenza and corona viruses from one person to another is still not fully understood. Methods: A literature search showed that there is a strong scientific rationale and evidence that viruses are very efficiently spread through aerosols by the patient's breathing only. It is not necessary for the patient to cough or sneeze. Results: The exhaled aerosol particles are generated by normal breathing in the deep lung through reopening of collapsed small airways during inspiration. These mucus/surfactant aerosols (size range between 0.2 and 0.6 µm) can transport viruses out of the lungs of patients and be present in the room air for hours. Conclusion: These aerosol particles are difficult to filter out of the air; because of their physical properties, new strategies must be developed to protect people from these virus aerosols.


Subject(s)
Aerosols , Coronavirus Infections/transmission , Pneumonia, Viral/transmission , Respiration , Betacoronavirus , COVID-19 , Humans , Pandemics , Personal Protective Equipment , SARS-CoV-2
17.
Sensors (Basel) ; 21(16)2021 Aug 20.
Article in English | MEDLINE | ID: covidwho-1376962

ABSTRACT

A fully automatic, non-contact method for the assessment of the respiratory function is proposed using an RGB-D camera-based technology. The proposed algorithm relies on the depth channel of the camera to estimate the movements of the body's trunk during breathing. It solves in fixed-time complexity, O(1), as the acquisition relies on the mean depth value of the target regions only using the color channels to automatically locate them. This simplicity allows the extraction of real-time values of the respiration, as well as the synchronous assessment on multiple body parts. Two different experiments have been performed: a first one conducted on 10 users in a single region and with a fixed breathing frequency, and a second one conducted on 20 users considering a simultaneous acquisition in two regions. The breath rate has then been computed and compared with a reference measurement. The results show a non-statistically significant bias of 0.11 breaths/min and 96% limits of agreement of -2.21/2.34 breaths/min regarding the breath-by-breath assessment. The overall real-time assessment shows a RMSE of 0.21 breaths/min. We have shown that this method is suitable for applications where respiration needs to be monitored in non-ambulatory and static environments.


Subject(s)
Respiration , Respiratory Rate , Algorithms , Monitoring, Physiologic , Respiratory System
18.
Sci Total Environ ; 805: 149970, 2022 Jan 20.
Article in English | MEDLINE | ID: covidwho-1372587

ABSTRACT

Particle concentration in a sitting person's breathing zone can be influenced by human movement around the person, and the transient and continuous effects may differ. In this study, a set of full-scale experiments was conducted to sample the nanoparticle concentration in the breathing zone of a sitting thermal breathing manikin (STBM). The transient fluctuation of the nanoparticle concentration was recorded continuously and analyzed. The results showed that when a manikin moved (at 1 m/s) past the STBM, the nanoparticle concentration in the STBM's breathing zone decreased and reached its lowest after the standing manikin had passed, decreasing 37.6 (±5.7) % compared with the peak value. The average concentration in the STBM's breathing zone during influence periods was 5.18 (±0.99) % less than that during non-influence Periods (NP). This finding reflected the fact that the transient inhalation (over several seconds) of the STBM may be reduced by manikin movement. On the other hand, the exposure of the STBM increased 2.88 (±1.24) % when there was a continuously moving manikin compared with the stable state in a 10-min observation. This finding may be explained by the fuller mix of indoor air and nanoparticles caused by manikin movement, as well as the increase of nanoparticle suspension time. The difference in the transient and continuous effects of the manikin movement on the STBM's exposure shows the importance of considering these effects separately in different scenarios.


Subject(s)
Air Pollution, Indoor , Nanoparticles , Humans , Manikins , Movement , Respiration , Sitting Position
19.
J Appl Physiol (1985) ; 131(2): 868-869, 2021 08 01.
Article in English | MEDLINE | ID: covidwho-1358932
20.
Nitric Oxide ; 116: 7-13, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1356375

ABSTRACT

BACKGROUND: Inhaled nitric oxide (NO) is a selective pulmonary vasodilator. In-vitro studies report that NO donors can inhibit replication of SARS-CoV-2. This multicenter study evaluated the feasibility and effects of high-dose inhaled NO in non-intubated spontaneously breathing patients with Coronavirus disease-2019 (COVID-19). METHODS: This is an interventional study to determine whether NO at 160 parts-per-million (ppm) inhaled for 30 min twice daily might be beneficial and safe in non-intubated COVID-19 patients. RESULTS: Twenty-nine COVID-19 patients received a total of 217 intermittent inhaled NO treatments for 30 min at 160 ppm between March and June 2020. Breathing NO acutely decreased the respiratory rate of tachypneic patients and improved oxygenation in hypoxemic patients. The maximum level of nitrogen dioxide delivered was 1.5 ppm. The maximum level of methemoglobin (MetHb) during the treatments was 4.7%. MetHb decreased in all patients 5 min after discontinuing NO administration. No adverse events during treatment, such as hypoxemia, hypotension, or acute kidney injury during hospitalization occurred. In our NO treated patients, one patient of 29 underwent intubation and mechanical ventilation, and none died. The median hospital length of stay was 6 days [interquartile range 4-8]. No discharged patients required hospital readmission nor developed COVID-19 related long-term sequelae within 28 days of follow-up. CONCLUSIONS: In spontaneous breathing patients with COVID-19, the administration of inhaled NO at 160 ppm for 30 min twice daily promptly improved the respiratory rate of tachypneic patients and systemic oxygenation of hypoxemic patients. No adverse events were observed. None of the subjects was readmitted or had long-term COVID-19 sequelae.


Subject(s)
COVID-19/drug therapy , Hospitalization , Nitric Oxide/administration & dosage , Pneumonia, Viral/drug therapy , Respiration/drug effects , Administration, Inhalation , COVID-19/complications , COVID-19/virology , Dose-Response Relationship, Drug , Humans , Nitric Oxide/pharmacology , Nitric Oxide/therapeutic use , Pneumonia, Viral/complications
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