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The combined use of inhaled nitric oxide and molecular hydrogen in patients with post-COVID-19 syndrome

Pozdnyakova DD, Baranova IA, Selemir VD, Medvedev OS, Chuchalin AG

Terapevticheskii arkhiv, 2026

60 participants

Abstract

Background: Medical gases, inhaled nitric oxide (iNO) and molecular hydrogen (iH2), have been used in the therapy for various medical conditions. When combined, these gases have shown to be more effective and safer for patients, and may become a promising treatment option for various diseases рost-COVID-19 syndrome (PS).

Aim: To compare the efficacy and safety of combined therapy iNO/iH2 with monotherapy iNO and a control group in patients with respiratory disorders during with PS.

Materials and methods: A prospective, open-label, controlled trial involving 60 patients with PS was conducted in parallel groups (the mean age of the participants was 58.1 ± 12.9 years, and the sample consisted of 18 men and 42 women). The participants were randomly assigned to 3 groups: 1 (n = 20) - iNO/iH2 treatment; 2 (n = 20) - only iNO treatment; and 3 (n = 20) - control group. The duration of treatment was 10 days, and the treatment involved inhalation through a nasal cannula for 90 minutes (flow rate of 4 liters per minute, iH2 concentrations < 4%, iNO - 60 pmm). Clinical outcomes were assessed using self-observation diaries, Modified Medical Research Council Dyspnea Scale questionnaires, the "Language of Dyspnea" Scale, Fatigue Assessment Scale, Hospital Anxiety and Depression Scale, and Short Form-36 Health Status Survey questionnaires. Additionally, a 6-Minute Walk Test was performed, and indicators of oxidative status in blood serum and microcirculation in the bulbar conjunctiva were…

How strong is the evidence?

Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 60 participants or records.

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