Short Commentary - (2021) Volume 7, Issue 2
Received: 07-Mar-2021
Published:
30-Mar-2021
, DOI: 10.37421/2472-1247.2021.07.166
Citation: Hareth D. Short note on Associated Lung Complications Clin Respir Dis Car 6 (2021):166. doi: 10.37421/jcrdc.2020.07.166
Copyright: 2021 Hareth. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
The majority of cases have spontaneously resolved. However, some have developed various fatal complications including organ failure, septic shock, pulmonary edema, severe pneumonia, and Acute Respiratory Distress Syndrome (ARDS)
This has marked the introduction of the third highly pathogenic and large-scale epidemic coronavirus into the human population in the twenty-first century after the Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) in 2002 and Middle East Respiratory Syndrome Coronavirus Given the lack of effective antiviral therapy against current treatments mainly focus on symptomatic and respiratory support. In this review, the role of management will be explored. We have conducted a thorough literature review basically by searching Medline, PubMed and Scopus for studies on COVID-19 and Given the possible harm from inhaled nitric oxide and the absence of a clear mortality benefit, recently published guidelines on the management of critically ill adults with Coronavirus Disease 2019 issued a strong recommendation against the routine use of nitric oxide in patients with ARDS. However, the guidelines recommend a trial of inhaled nitric oxide as a "rescue" therapy, after trying other options, in view of the finding of improved oxygenation. The guidelines further caution that if inhaled nitric oxide is used without a good response in terms of oxygenation, it should be tapered off to avoid rebound pulmonary vasoconstriction that can occur with prolonged use and abrupt discontinuation.While the activation of blood coagulation is essential in counteracting viral infections along with the immune system trapping viruses by forming a fibrin network, a massive inflammatory and coagulative response is dangerous because it can lead to a local thrombosis in the lungs. Furthermore, this severe acute inflammation induces a local consumption coagulopathy, i.e. Disseminated Intravascular Coagulopathy (DIC), resulting in ARDS. ARDS may be associated with pulmonary vascular microthrombosis The authors concluded that it is possible that these PAH-specific medications, including nitric oxide, may offer a protective benefit in COVID-19 patients through mediation of pulmonary vasodilatation, anti-proliferation and antithrombotic effect. Fernandes, et al. however, claim that these assumptions were based on little data at an early stage of the pandemic in the US, and the resulting speculations could mislead and put PAH patients at higher.
