Features of interleukin-19 production in patients with atherosclerosis

Objective. To study the features of local and systemic production of interleukin-19 in patients with atherosclerosis.Material and Methods. The study comprised a total of 46 patients (26 women and 20 men) treated for arterial hypertension in the therapeutic department of Republican Clinical Hospital named after G.Y. Remishevskaya. The mean age of subjects was 63.4 ± 3.2 years. The control group included 40 patients (23 women and 17 men aged 44.7 ± 5.5 years) who did not have atherosclerosis. Samples of atherosclerotic plaques and venous blood were examined. Atherosclerotic plaques were obtained by endarterectomy and then subjected to homogenization followed by enzymatic hydrolysis for 1 h at 37 °C with collagenase IV in the presence of proteinase III inhibitors. The serum levels of cytokines (in the control group and in patients with atherosclerosis) and in the atherosclerotic plaque homogenate (in patients with atherosclerosis) were determined by ELISA. To assess the cytokine-producing capacity of blood leukocytes and white blood cells isolated from atherosclerotic plaques, spontaneous and phytohemagglutinin (PHA)-induced cytokine production was determined when the cells were cultured in RPMI-1640.Results. The serum levels of IL-19 did not significantly differ between the patients with atherosclerosis and the control group. A statistically significant two-fold increase in the spontaneous expression of IL-19 by blood leukocytes was observed in the group of patients with atherosclerosis in comparison with the control group. When comparing the contents of IL-19 in blood serum and atherosclerotic plaque homogenate in patients with atherosclerosis, no statistically significant differences were found (p = 0.182). The level of PHA-induced IL-19 production by the atherosclerotic plaque white blood cells was significantly lower than that of blood leucocytes.Conclusion. The study showed that the reserve capacity for IL-19 synthesis in the atherosclerotic plaque white blood cells decreases leading to the progression of inflammation. The obtained results suggest that IL-19 plays the anti-atherogenic role and its production is involved in the maintaining the mechanisms for down-regulation of inflammation in atherosclerotic plaques.

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Study of blood levels of Lactate, Vitamin D and Nucleated Red Blood Cells for early prediction of Hypoxic–Ischemic Encephalopathy: A case-control study

10.21203/rs.3.rs-394858/v1 ◽

2021 ◽

Author(s):

Ahmed Hosni Saad ◽

Ahmed Thabet Mahmoud ◽

Mohamed Abdelrehem Soliman ◽

Alyaa Ahdy Abdelaziz

Keyword(s):

Vitamin D ◽

Red Blood Cells ◽

Blood Cells ◽

Venous Blood ◽

White Blood Cells ◽

Control Group ◽

Blood Levels ◽

P Value ◽

Nucleated Red Blood Cells ◽

Control Study

Abstract Objective and background: Perinatal asphyxia is a serious medical condition in which there is lack of oxygen or blood flow during, or even after the labor process. So, this study aimed to study serum blood levels of Lactate, vitamin D and count of nucleated Red Blood Cells (nRBCs) per 100 White Blood Cells (WBCs) as early biological predictors of Hypoxic–Ischemic Encephalopathy (HIE) after birth Asphyxia.Methods: A retrospective case-control study was conducted on 20 neonates with HIE comprising the cases (APGAR ≤ 5) and another 20 neonates representing the control group with their age, sex, and weight matched, admitted to NICU from March 2020 to the end of September 2020 at Menoufia University Hospital and El-Bagour Central Hospital, Egypt. Venous blood samples for lactate, vitamin D and nucleated RBCs were drawn during 1st 6h of birth and sent for analysis. Sarnat score was used to assess the severity of HIE.Results: Venous blood levels of lactate and nucleated Red Blood Cells per 100 White Blood Cells (nRBC/100 WBC) counts were significantly higher in HIE neonates than in the control group with a highly significant difference (P-value < 0.001). While serum Vitamin D was significantly lower in the HIE group than in the control (P-value < 0.001).Conclusion: Serum lactate level, vitamin D level and nRBCs/100 WBCs might be used as biomarkers in the early prediction of HIE.

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The effect of lead exposure on tracheal responsiveness to methacholine and ovalbumin, total and differential white blood cells count, and serum levels of immunoglobulin E, histamine, and cytokines in guinea pigs

Human & Experimental Toxicology ◽

10.1177/0960327113499040 ◽

2013 ◽

Vol 33 (3) ◽

pp. 325-333 ◽

Cited By ~ 9

Author(s):

T Farkhondeh ◽

MH Boskabady ◽

S Jalali ◽

G Bayrami

Keyword(s):

Blood Cells ◽

Guinea Pigs ◽

Lead Acetate ◽

Immunoglobulin E ◽

White Blood Cells ◽

Serum Levels ◽

Control Group ◽

Significant Difference ◽

Ifn Γ ◽

Pb Concentration

The effect of exposure to inhaled lead acetate in guinea pigs was evaluated. The present study comprised of five groups of guinea pigs including control (C), sensitized to ovalbumin (OA; S) and three groups exposed to 0.1, 0.2, and 0.4 M inhaled lead (Pb; n = 6 for each group). Tracheal responsiveness to methacholine and OA, total and differential white blood cells (WBCs) count in lung lavage, serum levels of cytokines (interferon γ (IFN-γ) and interleukin 4 (IL-4)), histamines, and immunoglobulin E (IgE), and Pb concentration in lung were measured. Tracheal responsiveness to methacholine, OA, total and differential WBC types as well as IL-4, IFN-γ, histamine, and IgE were significantly increased but IFN-γ/IL-4 were significantly decreased in sensitized animals as well as those exposed to high Pb concentrations when compared with the control group (from p < 0.05 to p < 0.001). In addition, there was not a significant difference in most measured values between animals exposed to high Pb concentration and group S. The Pb concentration in lung tissues of animals exposed to all three Pb concentrations was significantly higher than that of group C ( p < 0.001 for all cases).These results showed that inhaled lead acetate exposure can induce lung inflammatory changes similar to sensitized animals. Therefore, exposure to environmental Pb pollution may cause asthma-like changes.

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The Significance of Spermidine and Spermine in Association with Atherosclerosis in Sera of Iraqi Patients

Biomedical & Pharmacology Journal ◽

10.13005/bpj/1502 ◽

2018 ◽

Vol 11 (3) ◽

pp. 1389-1396 ◽

Cited By ~ 2

Author(s):

Suhad A.Ibrahim ◽

Jwan A. Zainulabdeen ◽

Hameed M. Jasim

Keyword(s):

Red Blood Cells ◽

Blood Cells ◽

White Blood Cells ◽

Coronary Intervention ◽

Serum Levels ◽

Hplc Method ◽

Control Group ◽

Percutaneous Coronary ◽

Patient Groups ◽

Positive Correlations

This study aims to determine the relationship between spermidine (SPD) and spermine (SPM) with the incidence of atherosclerosis in population of Iraqi patients in comparison with controls. A total of 128 atherosclerosis patients (64 male and 64 female) were included in the present study (aged 45-70 years). They were categorized into two groups: a group that underwent percutaneous coronary intervention catheterization (PCI) and a group that underwent diagnostic catheterization (DIG). 64 age matched, apparently healthy individuals (showing no symptoms of heart disease) of both men and women were also included in the control group (C). Sera were used as samples of the present study; the main measurements included SPD and SPM levels using the HPLC method. Results showed that serum levels of SPD were 631.53 ± 35.637, and 540.49 ± 44.564µg/ml in PCI and DIG patients, respectively. These levels showed significant increases (p˂0.001) when compared to their levels (29.162 ± 6.151µg/ml) in sera of healthy controls. On the other hand, the SPM levels were (159.98 ± 15.981, and 169.85 ±14.606 µg/ml) in PCI and DIG patients, respectively, which also show significant increases (p˂0.001) when compared with the SPM levels (24.26 ± 4.613 µg/ml) in the control group. Moreover, the changes in SPD and SPM levels differed significantly (p˂0.001, and p˂0.05, respectively) according to gender in patient groups. Moreover, it was found that there were positive correlations between sera levels of SPD and SPM in atherosclerosis patients with the levels of white blood cells (WBC) (r=0.58, p˂0.05, r=0.55, p˂0.05), neutrophils (r=0.54, p˂0.05, r=0.51, p˂0.05), lymphocytes (r=0.46, p˂0.05, r=0.48, p˂0.05) and red blood cells (RBC) (r=0.43, p˂0.05, r=0.60, p˂0.01). These results demonstrated that SPD and SPM levels were altered in sera of atherosclerosis patients when compared with the control group. In addition, the data indicated that these patients’ gender played a role in their levels. Generally, correlations were observed among the SPD and SPM levels, the white blood cell differential, and the red blood cells in the sera of atherosclerosis patients.

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Ferulic Acid against Cyclophosphamide-Induced Heart Toxicity in Mice by Inhibiting NF-κB Pathway

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2016/1261270 ◽

2016 ◽

Vol 2016 ◽

pp. 1-8 ◽

Cited By ~ 9

Author(s):

Yafan Song ◽

Chunyan Zhang ◽

Congxia Wang ◽

Ling Zhao ◽

Zheng Wang ◽

...

Keyword(s):

Single Dose ◽

Ferulic Acid ◽

Blood Cells ◽

White Blood Cells ◽

Serum Levels ◽

Control Group ◽

Protective Effects ◽

Cardiac Tissues ◽

Mechanism Research ◽

Induced Changes

The purpose of the present study was to elucidate the protective effects of ferulic acid (FA) against cyclophosphamide- (CTX-) induced changes in mice. Forty-eight male ICR mice were divided into four groups. Control group was intraperitoneally (i.p.) injected with 200 μL of phosphate buffer saline (PBS). Model group was intraperitoneally injected with a single dose of CTX (200 mg/kg). FA (50 mg/kg) and FA (100 mg/kg) groups were intraperitoneally injected with a single dose of CTX (200 mg/kg) followed by the intragastric treatment with FA (50, 100 mg/kg) for 7 consecutive days. After 12 d, the mice were sacrificed to analyze the hematological, biochemical, histological parameters and mechanism research. The results indicated that FA significantly decreased the serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatine kinase (CK), lactate dehydrogenase (LDH), interleukin-6 (IL-6), IL-1β, and tumor necrosis factor-α(TNF-α) in CTX-injected mice. In addition, FA effectively reduced the total numbers of white blood cells (WBCs), red blood cells, platelets, and hemoglobin content. FA also obviously attenuated the histological changes of the heart tissues caused by CTX. Moreover, Western blot demonstrated that FA inhibited the phosphorylations of NF-κB signaling pathway in CTX-stimulated cardiac tissues. In conclusion, FA might be considered as an effective agent in the amelioration of the heart toxicity resulting from CTX treatment.

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Effects of dietary Mannan oligosaccharide (MOS) on grown, survival rate, intestinal morphology and blood cell count of the golden trevally fish (Gnathanodon specious)

Tạp chí Khoa học và Công nghệ Biển ◽

10.15625/1859-3097/19/4a/14600 ◽

2019 ◽

Vol 19 (4A) ◽

pp. 241-250

Author(s):

Dang Tran Tu Tram ◽

Nguyen Thi Nguyet Hue ◽

Ho Son Lam ◽

Nguyen Truong Tan Tai ◽

Dao Thi Hong Ngoc

Keyword(s):

Survival Rate ◽

Blood Cell ◽

Blood Cells ◽

White Blood Cells ◽

Intestinal Morphology ◽

The Other ◽

Control Group ◽

Blood Cell Count ◽

Mannan Oligosaccharide ◽

Erythrocyte Density

The golden trevally fishes (Gnathanodon specious) (2.19 ± 0.23 g) were cultured in glass tanks with density of 20 fishes/tank and they were fed supplemental diets of different MOS concentrations (0; 0.2; 0.4 and 0.6%) for 90 days. Collected data included growth rate, survival rate and some hematological characteristics of this fish. The results demonstrated that MOS supplementation did not affect growth performance, erythrocyte density and blood cell size, however the survival rate was significantly increased. On the other hand, the total number of white blood cells (BC) on the 60th day in the fish fed with MOS supplements (5.78–6.96 × 104TB/mm3) was higher than that in the control group (only 5.43 × 104TB/mm3) with the largest total leukocytes (6.96 ± 0.50 × 104TB /mm3) at 0.2% MOS (p < 0.05).

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EFFECT OF ZINC ELEMENT AND DEXAMETHASONE ON SOME HEMATOLOGICAL BIOCHEMICAL TESTS IN RABBITS MALE

IRAQI JOURNAL OF AGRICULTURAL SCIENCES ◽

10.36103/ijas.v47i6.484 ◽

2016 ◽

Vol 47 (6) ◽

Author(s):

D. S. Dheyab

Keyword(s):

Blood Cells ◽

White Blood Cells ◽

The Body ◽

Control Group ◽

Blood Collection ◽

Biochemical Tests ◽

Histological Changes ◽

Spleen Tissue ◽

Cholesterol Levels ◽

Short Time

This study was conducted to investigate the effect of zinc in dose 15mg/kg.bw daily taken by the mouth and dexamethasone 4mgIkg.Bw by injection for 30days on some hematological biochemical tests and some histological changes of liver spleen in male rabbits. Thirty rabbits were used that divided into 3 randomized groups (each group contain 10 male rabbits ). Control group was taken normal food and water, Zinc group that gave zinc at dose of 15mg/kg.BW/daily/oral on 1, 2, 3, 4 weeks. Dexamethasone with zinc group : Employ dexamethasone 4mg/Kg.Bw . I.M dialy for 1 and 2 weeks for experiment and at 3, 4th weeks they gave zn 15mg/lKg.Bw day/orally. Blood samples were taken from the heart directly in 2 and 4weeks to examine packed cell volume (pcv), white blood cells (WBCs), Red blood cells (RBCs) with differential Leuckcyte count.separation blood collection to plasma and examine glucose mg/dl , cholesterol mg/dl. In histological tests, rabbits were killed and separate their organs tissue from the body to examine liver and spleen. The results revealed a decrease in level of RBCs, pcv after treatment with zinc 15, mg/Kg.Bw orally (zinc group) and increase in WBCs with differential leuckocyte count specially neutrophil cell, while biochemical tests show increase in glucose and cholesterol levels after treatment with dexamethasone 4mglkgBw. I/M seen increase in counts of RBCs , PCV, WBCs and differential lenkocyte count and decrease in glucose with cholesterol parameters, histological changes show change in liver after treatment by dexamethasone 4mglKg.Bw ,spleen tissue seen necrosis and pigmentation with hemorrhage after take dexamethasone 4mglkg in (dexamethasone + zinc group). Results also showed that zinc enhanced the immune system in at normal dose for limited time because of its effect on other mineral such as copper and causes anemia , while the dexamethasone is a drug used for antianflammatory but for a short time.

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EFFECT OF VARIOUS FORMS OF SELENIUM ON THE PRODUCTIVITY AND METABOLISM OF FATTENED YOUNG PIGS IN PRODUCTION CONDITIONS

Izvestiâ Timirâzevskoj selʹskohozâjstvennoj akademii ◽

10.26897/0021-342x-2021-1-55-65 ◽

2021 ◽

pp. 55-65

Author(s):

M.G. CHABAEV ◽

◽

E.YU. TSIS ◽

R.V. NEKRASOV ◽

M.I. KLEMENTEV

Keyword(s):

Blood Cells ◽

Average Daily Gain ◽

White Blood Cells ◽

Live Weight ◽

Growing Pigs ◽

Control Group ◽

Protein Activity ◽

Large White ◽

Organic Selenium ◽

Young Pigs

Selenium plays an important role for maintaining complex and adequate nutrition of fattened young pigs. It also has a big biological importance to maintain growth and health, as well as for biochemical and physiological processes This study presents the results of a production experiment to determine the effect of organic and inorganic forms of selenium on growth indicators, immunohematological blood parameters and slaughter qualities of fattened pigs in period I and II. Test feeding with various forms of selenium has been implemented with two groups of analogs (N = 60; n = 30), taking into account age and live weight. The experiment was conducted on castrates of large white breed, which were divided into two groups of 30 heads each following the principle of analogues (taking into account their age, live weight). The studied fattened pigs received standard complete feeds of the SK-5 and SK-6 types for a period of 105 days. Growing pigs were fed with organic selenium for 20 mg/kg as part of the feed 64 mixture per head in the first and second period of fattening, while the animals of the control group were fed with 0.3 mg/kg of the inorganic form of selenium. Including a chelated form of selenium in the complete feed of castrates at the rate established in the course of scientific and economic studies has led to 757 g of average daily gain, which is 8.1% more as compared to the control group. The concentration of red blood cells in the blood of growing pigs fed with 20 mg/kg of selenium chelate increased by 6.3%, hemoglobin – by 2.4%, and white blood cells – by 7.1% as compared to the control. Feeding organic selenium to fattened young pigs contributed to a significant increase in specific units of protein activity by 38.65% (p < 0.01), BASC – by 7.63%, as well as lysis – by 40.06% (p < 0.05), and phagocytic activity by 3.33% in blood serum as compared to the control. The half-carcasses of hogs who had received fed rations including selenium chelate fetured slaughter weight and slaughter yield, respectively, higher – by 6.4 and 0.6% as compared with the control analogues. The use of the established norm of organic selenium in the diets of fattened young pigs according to the results of production testing is economically profitable and contributes to a per-head profit of 420 rubles.

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Effects of Inclusion of Different Doses of Persicaria odorata Leaf Meal (POLM) in Broiler Chicken Feed on Biochemical and Haematological Blood Indicators and Liver Histomorphological Changes

Animals ◽

10.3390/ani10071209 ◽

2020 ◽

Vol 10 (7) ◽

pp. 1209 ◽

Cited By ~ 1

Author(s):

Muhammad Abdul Basit ◽

Arifah Abdul Kadir ◽

Teck Loh ◽

Saleha Abdul Aziz ◽

Annas Salleh ◽

...

Keyword(s):

Growth Performance ◽

Blood Cells ◽

Broiler Chickens ◽

White Blood Cells ◽

Serum Levels ◽

Linear Increase ◽

The Body ◽

Leaf Meal ◽

Serum Activity ◽

Haematological Indices

This research was conducted to estimate the effects of Persicaria odorata leaf meal (POLM) on haematological indices, serum biochemical attributes, and internal organs parameters, including histomorphological features of the liver, in broiler chickens. A total of 120 one-day-old male broiler chicks (Cobb-500) were randomly allocated into four experimental groups. The dietary treatments were basal diet (BD), which served as the control (C), along with BD + 2 g/kg POLM (Po2), BD + 4 g/kg POLM (Po4), BD + 8 g/kg POLM (Po8), which were the supplemented groups. The body weight gain (BWG) showed a linear increase and feed conversion ratio (FCR) showed a linear decrease with increasing POLM dosage at day 42 (p ˂ 0.05) and for the overall growth performance period (p ˂ 0.01). On day 21 and day 42, the values of red blood cells (RBCs), white blood cells (WBCs), haemoglobin (Hb), and packed cell volume (PCV) showed linear increases (p ˂0.05) as the dosage of POLM increased in the diet. On day 21, dietary supplementation of POLM linearly decreased (p ˂ 0.05) the serum activity of alkaline phosphatase (ALP), aspartate aminotransaminase (AST), alanine aminotransaminase (ALT), and serum levels of urea and creatinine. On the other hand, serum levels of total protein (TP), albumin, and globulin showed a linear increase (p ˂ 0.05) as the POLM dosage increased. On day 42, the serum activity of AST and ALT and serum levels of glucose, cholesterol, triglycerides, urea, and creatinine showed linear decreases (p ˂ 0.05) with increased levels of POLM in the diet. However, POLM supplementation linearly increased (p ˂ 0.05) the serum levels of TP and globulin. Dietary inclusion of POLM did not influence the organ parameters and showed no adverse effects on the liver histomorphology. In conclusion, supplementation of POLM increased the growth performance, improving haematological indices and serum biochemistry profiles of broiler chickens without any deleterious effects on the liver histomorphology. The results of the present study provide evidence that POLM can be safely used at a dose rate of 8 g/kg of feed as an alternative to conventional antimicrobial growth promoters (AGPs).

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Effects of carprofen or meloxicam on selected haemostatic variables in miniature pigs after orthopaedic surgery

Acta Veterinaria Brno ◽

10.2754/avb201180040401 ◽

2011 ◽

Vol 80 (4) ◽

pp. 401-405 ◽

Cited By ~ 1

Author(s):

Petr Raušer ◽

Leona Lexmaulová ◽

Robert Srnec ◽

Lucie Urbanová ◽

Pavel Proks ◽

...

Keyword(s):

Blood Cells ◽

Bleeding Time ◽

White Blood Cells ◽

Intramuscular Administration ◽

Control Group ◽

Thrombin Time ◽

Serum Urea ◽

Miniature Pigs ◽

Analgesic Effects ◽

Biochemical Variables

The aim of the study was to detect and compare the haemostatic variables and bleeding after 7‑days administration of carprofen or meloxicam in clinically healthy miniature pigs. Twenty-one clinically healthy Göttingen miniature pigs were divided into 3 groups. Selected haemostatic variables such as platelet count, prothrombin time, activated partial thromboplastin time, thrombin time, fibrinogen, serum biochemical variables such as total protein, bilirubin, urea, creatinine, alkaline phosphatase, alanine aminotransferase and gamma-glutamyltransferase and haemoglobin, haematocrit, red blood cells, white blood cells and buccal mucosal bleeding time were assessed before and 7 days after daily intramuscular administration of saline (1.5 ml per animal, control group), carprofen (2 mg·kg-1) or meloxicam (0.1 mg·kg-1). In pigs receiving carprofen or meloxicam, the thrombin time was significantly increased (p< 0.01) compared to the control group. In animals receiving carprofen, serum urea and creatinine were significantly decreased, compared to the control (p< 0.01) or meloxicam (p< 0.05) groups. In pigs receiving meloxicam, serum urea was significantly decreased (p< 0.05) compared to the control group. Significant differences were not detected in other haemostatic, biochemical variables or bleeding time compared to other groups or to the pretreatment values. Intramuscular administration of carprofen or meloxicam in healthy miniature pigs for 7 days causes sporadic, but not clinically important changes of selected haemostatic variables. Therefore, we can recommend them for perioperative use, e.g. for their analgesic effects, in orthopaedic or other surgical procedures without increased bleeding.

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Silent hypoxia: higher NO in red blood cells of COVID-19 patients

BMC Pulmonary Medicine ◽

10.1186/s12890-020-01310-8 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Esmaeil Mortaz ◽

Majid Malkmohammad ◽

Hamidreza Jamaati ◽

Parisa Adimi Naghan ◽

Seyed MohamadReza Hashemian ◽

...

Keyword(s):

Red Blood Cells ◽

Blood Cells ◽

Diffuse Alveolar Damage ◽

Serum Levels ◽

Pulmonary Involvement ◽

Clinical Feature ◽

Control Group ◽

Small Vessels ◽

Control Subjects ◽

Healthy Control

Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes coronavirus disease 2019 (COVID-19) has spread to almost 100 countries, infected over 31 M patients and resulted in 961 K deaths worldwide as of 21st September 2020. The major clinical feature of severe COVID-19 requiring ventilation is acute respiratory distress syndrome (ARDS) with multi-functional failure as a result of a cytokine storm with increased serum levels of cytokines. The pathogenesis of the respiratory failure in COVID-19 is yet unknown, but diffuse alveolar damage with interstitial thickening leading to compromised gas exchange is a plausible mechanism. Hypoxia is seen in the COVID-19 patients, however, patients present with a distinct phenotype. Intracellular levels of nitric oxide (NO) play an important role in the vasodilation of small vessels. To elucidate the intracellular levels of NO inside of RBCs in COVID-19 patients compared with that of healthy control subjects. Methods We recruited 14 COVID-19 infected cases who had pulmonary involvement of their disease, 4 non-COVID-19 healthy controls (without pulmonary involvement and were not hypoxic) and 2 hypoxic non-COVID-19 patients subjects who presented at the Masih Daneshvari Hospital of Tehran, Iran between March–May 2020. Whole blood samples were harvested from patients and intracellular NO levels in 1 × 106 red blood cells (RBC) was measured by DAF staining using flow cytometry (FACS Calibour, BD, CA, USA). Results The Mean florescent of intensity for NO was significantly enhanced in COVID-19 patients compared with healthy control subjects (P ≤ 0.05). As a further control for whether hypoxia induced this higher intracellular NO, we evaluated the levels of NO inside RBC of hypoxic patients. No significant differences in NO levels were seen between the hypoxic and non-hypoxic control group. Conclusions This pilot study demonstrates increased levels of intracellular NO in RBCs from COVID-19 patients. Future multi-centre studies should examine whether this is seen in a larger number of COVID-19 patients and whether NO therapy may be of use in these severe COVID-19 patients.

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