The INOpulse inhaled nitric oxide system device (Image courtesy Bellerophon Therapeutics)
A gas made in your body that eases breathing and may have antiviral properties is being investigated as a treatment for people with COVID-19.
The gas is nitric oxide, and it has been used for years to treat conditions including severe respiratory failure, according to Dr. Shilpa Johri of Pulmonary Associates of Richmond.
Nitric oxide dilates blood vessels in the lungs and elsewhere by relaxing smooth muscle. There also are some indications that its use had antiviral properties, observed in the early 2000s when it was used in China during an outbreak of another coronavirus, one responsible for Severe Acute Respiratory Syndrome (SARS).
Johri is using a device, the INOpulse inhaled nitric oxide system, to treat patients in Richmond. The device is from the New Jersey-based Bellerophon Therapeutics. It is designed to deliver a consistent and accurate dose of nitric oxide into the lungs. It’s hoped that use of the device may stabilize patients and prevent the need for a ventilator, thus allaying demand for the devices, which are in short supply. In March the U.S. Food and Drug Administration approved its use to treat people with COVID-19 under the Emergency Expanded Access program.
Bellerophon reports that three people have completed treatment on the device so far; two have been discharged. “We continue to collaborate closely with the FDA and medical centers around the country to make INOpulse available to as many patients as possible as quickly as we can,” says Dr. Hunter Gillies, Bellerophon’s chief medical officer, in a release.
Johri says she was already familiar with the device through clinical work. She describes it as simple and easy to use. “The gas itself has been well known in medicine for years,” she says. The device is small and portable, and the patient can be treated in other areas of a hospital with it, outside of an intensive care unit. It’s also less invasive, with the gas administered through a nasal cannula, the plastic tube with two prongs on the end that are placed in each nostril.
“The treatment itself is as simple as taking a breath in,” Johri says.
It’s being used here for people with COVID-19 infections described as moderate in severity, those who have symptoms, but not severe enough to necessitate treatment in an intensive care unit. People will be treated for periods ranging from three days to two weeks. This is not a randomized medical trial; it’s a treatment, and patients are aware that they are receiving it and are made aware of potential risks and benefits, says Johri. It is an investigational treatment, Johri notes, and it is provided at no cost to selected patients.
On Tuesday, Johri had eight patients in Richmond receiving treatment and added two that day. She’s at Bon Secours St. Mary’s Hospital, but information on the availability of the treatment has been forwarded to other Richmond hospitals as well. “We would be happy to screen the patients,” she says.
She adds that she’s excited by the potential for the treatment. COVID-19 is unpredictable and can devastate the lungs, and someone with the virus can deteriorate rapidly, requiring ICU treatment and being placed on life support.
“Anything that can perhaps mitigate or prevent the need of a ventilator is very exciting,” she says.
Learn more about the use of the gas in treating COVID-19 patients in a study at a Massachusetts hospital in a report from Boston NPR station WBUR-FM.
