Claritas Pharmaceuticals, Inc. announced that a recently published study led by clinicians at Royal Brompton & Harefield NHS Foundation Trust1 validates the potential of the Company’s proprietary nitric oxide releasing compound, R-107, as a potential therapy for coronavirus and COVID-19 infection. In the cited study, inhaled nitric oxide was seen to significantly improve oxygen levels administered in patients with severe COVID-19 pneumonia. The study at Royal Brompton & Harefield NHS Foundation Trust was the large of its kind worldwide. In this study, 35 Patients with COVID-19 pneumonia who were on ventilation were given inhaled nitric oxide as part of routine care when they were failing to respond to best standard treatments. This led to significant improvements in oxygen levels and improvements in ventilatory efficiency at 24 hours and for up to five days. COVID-19 is caused by a coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Claritas is developing R-107 for the potential treatment of vaccine resistant COVID-19 infection and pulmonary arterial hypertension (“PAH”). R-107 is a proprietary nitric oxide-releasing compound. Following administration, R-107 enters the bloodstream, where it slowly releases nitric oxide systemically over 24 hours. Nitric oxide is a natural molecule with antiviral properties that is produced by the body itself. It is an integral part of the body’s natural defense system. When a viral threat is present, white blood cells migrate to the area of infection and release a burst of nitric oxide that crosses into the infected cell and inactivates the virus, so that it is incapable of further replication and spread. Nitric oxide is known to have a broad antiviral activity against multiple viruses, including those whose genes are encoded by RNA, so-called “RNA viruses”.2 The SARS-CoV-2 virus, which is responsible for COVID-19 infection, is an RNA virus. Other RNA viruses of importance that cause human disease include influenza, SARS, the common cold, hepatitis C, hepatitis E, West Nile fever, rabies, and measles. The historical challenge with nitric oxide therapy has been the difficulty of delivering the molecule in an effective and practical manner. Nitric oxide exists as a gas must be delivered by inhalation therapy requiring use of a CPAP-like device and administration by trained respiratory therapists. When inhaled, nitric oxide gas is absorbed into the lung tissues, where it has a half-life of only a few seconds. Accordingly, it is believed that inhaled nitric oxide may eliminate virus in the lungs, but does not survive long enough within the circulation to reach distant organs and eliminate their viral infection. R-107, on the other hand, is a breakthrough compound designed to overcome the limitations of nitric oxide inhalation therapy. R-107 is a liquid that may be readily administered orally in a capsule, or by an intramuscular or subcutaneous injection. Following administration, R-107 enters the bloodstream, where it is stable and can slowly release nitric oxide systemically over 24 hours. R-107’s systemic release of nitric oxide would thus potentially allow elimination of virus in all organs and tissues, not only in the lungs. Most patients who contract COVID-19 have mild or moderate symptoms like coughing, a fever, and shortness of breath. However, about 15% of patients develop severe infection and often present with pneumonia in both lungs. Pulmonary arterial hypertension (“PAH”) is a frequent complication of COVID-19 pneumonia. The spike protein of the COVID-19 virus damages the endothelium, the lining of the blood vessels. In the blood vessels of the lungs, this damage results in clots that increase pulmonary blood pressure. As the blood vessels in the lung are progressively blocked by clots and become engorged with blood, arterial blood pressure or PAH increases, leading to acute stress and ballooning of the right side of the heart. This stress on the right side of the heart may become unsupportable and cardiac failure and death ensue. In the gold-standard animal model of PAH, R-107 was seen to prevent damage to the lining of blood vessels in the lungs and to protect the right side of the heart from PAH and cardiac failure. In this study, R-107 profoundly and immediately reduced PAH.