This randomized, controlled trial will assess the efficacy and safety of pulsed iNO in subjects with COVID-19 who are hospitalized and require supplemental oxygen.
Drug: Inhaled nitric oxide (iNO)
iNO Pulse 250 mcg/kg ideal body weight (IBW)/hour
Drug: Nitrogen gas
250 mcg/kg ideal body weight (IBW)/hour
Drug: Oxygen gas
Supplemental oxygen administered via nasal cannula
Inclusion Criteria:
1. Age 18 or above
2. Proven COVID-19 viral infection. Non-confirmed highly suspicious suspects may be
enrolled.
3. Presence of radiographic findings compatible with pneumonia/pneumonitis.
4. Patients requiring at least 3 L/m oxygen via nasal canula to maintain O2 above 92%.
5. Female subjects of childbearing potential must have a negative pre-treatment pregnancy
test (serum or urine).
6. Willing and able to comply with treatment schedule and study procedures.
Exclusion Criteria:
1. Patient with severe hypoxemia who are unable to maintain an oxygen saturation (SpO2) >
88% on a maximum supplemental oxygen of 6 L/m by nasal cannula and a non-rebreather
facemask.
2. Participating in any other clinical trial for COVID-19
3. Pregnancy, or positive pregnancy test in a pre-dose examination.
4. Open tracheostomy.
5. Clinical contra-indication, as deemed by the PI or their designee.
6. Use of a nitric oxide donor agent such as nitroglycerin or drugs known to increase
methemoglobin such as intravenous lidocaine, or topical benzocaine or dapsone at
screening.
7. Known history or clinical evidence of heart failure or left ventricular dysfunction
(LVEF < 45%).
8. Significant hemoptysis
9. Unable to provide informed consent (proxy consent is acceptable if available)
10. Any of the following conditions at time of possible enrollment: Fulminant Liver
Failure, Acute Coronary Syndrome , Renal Failure requiring dialysis, Bacteremia,
Shock, Cardiac arrest, Cardiac arrhythmia requiring acute treatment, Delirium /
Encephalopathy, Severe Disseminated Intravascular Coagulation, Gastrointestinal
hemorrhage, Hypoglycemia, Pneumothorax, Rhabdomyolysis / Myositis, Seizures, or Acute
Stroke
University of Miami Hospitals & Clinics
Miami, Florida, United States
Roger A Alvarez, D.O., Principal Investigator
University of Miami