Rescue Therapy for Pregnant Women with Severe COVID-19

Inhaled nitric oxide, a selective pulmonary vasodilator, was administered to six pregnant women with severe or critical COVID-19 (including two receiving mechanical ventilation) between April and June 2020. The treatment was delivered twice daily to women receiving supplemental oxygen and continuously to women who were mechanically ventilated.

The treatment led to improvements in systemic oxygenation and shortness of breath and a decrease in respiratory rate. All six women recovered. Nitric oxide was well tolerated; methemoglobinemia, a known side effect, peaked on average at 2.5%. Five of the women delivered six newborns; one woman with twins had acute respiratory distress, shock, and acute kidney injury, necessitating cesarean delivery at …