The Effects of Nitrate-Based Nutritional Formula on Oxygen Saturation and Patient-Reported Outcomes in COVID-19 Patients: A Randomized Controlled Trial

The main objective of this randomized controlled trial was to analyze the acute effects of a nitrate-based nutritional formula on peripheral oxygen saturation (SpO2), patient-reported outcomes, and safety indices in patients with acute COVID-19 infection. The participants completing the protocol for the trial (n = 71) were allocated in a double-blind design to receive either a multicomponent nutritional formula (containing 1200 mg of potassium nitrate, 200 mg of magnesium, 50 mg of zinc, and 1000 mg of citric acid), or a placebo (2.5 g of inulin) during a 72-h monitoring period. All participants were requested to take an intervention (four capsules; weight of each capsule was ~2.5 g) every 4 h during the intervention period. A two-way mixed model ANOVA with repeated measures revealed a significant difference in SpO2 between interventions (P = 0.007). As many as 30 out of 38 patients (78.9%) receiving nitrate-based nutritional formula, who all started the treatment with SpO2 ≤ 95%, finished the intervention with SpO2 of at least 95% at 72-h follow-up, whereas in the placebo group, 13 patients out of 33 (39.4%) finished the trial with SpO2 of at least 95% (P < 0.05). The hospital admission rate after the 72-h follow-up was 21.1% in patients receiving nitrate-based formula compared to 33.3% in the placebo group (P = 0.25). The nitrate-based formula might be recognized as a potent strategy to tackle hypoxemia and concomitant features of the COVID-19 pandemic. In conclusion, it appears that the novel nitrated-based nutritional formulation described here was able to improve oxygen saturation and clinical outcomes in COVID-19 patients. Although the exact mechanism of action remains unknown, the nitrate-based formula might be recognized as a potent, safe, and convenient strategy to tackle hypoxemia and concomitant features of the COVID-19 pandemic.