The role of NO in COVID-19 and potential therapeutic strategies

• Published in: Free radical biology & medicine Vol. 163; pp. 153 - 162
• Main Authors: Fang, Wanyi, Jiang, Jingrui, Su, Lei, Shu, Tong, Liu, Huan, Lai, Shenghan, Ghiladi, Reza A., Wang, Jun
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-02-2021
• Subjects: Administration, Inhalation; Anti-inflammation; Anti-Inflammatory Agents - blood; Anti-Inflammatory Agents - therapeutic use; Anti-viral; Anticoagulants - blood; Anticoagulants - therapeutic use; Antiviral Agents - blood; Antiviral Agents - therapeutic use; COVID-19; COVID-19 - blood; COVID-19 - pathology; COVID-19 - virology; COVID-19 Drug Treatment; Endothelial Cells - drug effects; Endothelial Cells - pathology; Endothelial Cells - virology; Humans; Inflammation; Lung - blood supply; Lung - drug effects; Lung - virology; Mitochondria - drug effects; Mitochondria - virology; Nitric oxide; Nitric Oxide - blood; Nitric Oxide - therapeutic use; Review; SARS-CoV-2 - drug effects; SARS-CoV-2 - pathogenicity; Severity of Illness Index; Vasodilation; Vasodilation - drug effects; COVID-19; Anti-viral; Nitric oxide; Vasodilation; Anti-inflammation
• ISSN: 0891-5849; 1873-4596; 1873-4596
• DOI: 10.1016/j.freeradbiomed.2020.12.008

Nitric oxide (NO) is a free radical playing an important pathophysiological role in cardiovascular and immune systems. Recent studies reported that NO levels were significantly lower in patients with COVID-19, which was suggested to be closely related to vascular dysfunction and immune inflammation among them. In this review, we examine the potential role of NO during SARS-CoV-2 infection from the perspective of the unique physical, chemical and biological properties and potential mechanisms of NO in COVID-19, as well as possible therapeutic strategies using inhaled NO. We also discuss the limits of NO treatment, and the future application of this approach in prevention and therapy of COVID-19.
[Display omitted]
•Decreased NO level and bioavailability has been observed in patients with COVID-19.•SARS-CoV-2 infection may cause NO dysfunction in cells and tissue via four pathways.•Inhaled NO might participate in multiple stages of COVID-19 prevention or therapy.