CORONAVIRUS             Finnish

 Does nitric oxide protect children from severe symptoms of  COVID -19 and could early interventions on the nitric oxide pathway increase immunity against SARS CoV 2 coronavirus?
The hypotheses consist of three premises. First, the age-related drop in the production of nitric oxide (NO) in the endothelium (Torregrossa 2011). Second, L-arginine is involved in the chemical reaction of NO formation (Torregrossa 2011) that inhibits the replication cycle of SARS CoV coronavirus (Åkerström 2005, Åkerström 2009). Third, and related to the previous point, L-arginine is an essential amino acid in the formation of coronaviruses (Tsui-Yi Peng 2008).
The first hypohesis is that coronaviruses possibly cause a substantial decrease of NO levels in the human body; a vicious cycle ensues which presumeably accounts for  extremely fast progress of COVID-19.
Because NO deficiency has been connected with mitocondrial diseases (El-Hattad 2012), my second hypothesis is that the fatigue linked to COVID-19 symptoms may result from mitocondric disorders rooted from insufficient levels of NO in the human organs.
Calcium and iron are involved in chemical reactions in producing NO (Torregrossa 2011). Consequently, my third hypothesis is that the availability of these nutrients in the body could lead to better immunity against COVID-19.
As it has been observed with patients suffering from herpes viruses (Fay 2017), L-lysine may have a negative impact on the formation  of SARS CoV 2 viruses  (Muller 2016), which is my fourth hypothesis.
Because arginine-NO pathway functions well in childhood (Torregrossa 2011), my fifth and final hypothesis is that NO is the factor which accounts for the children's mild or even non-existent symptoms of  COVID-19.
Could natural interventions which have been proven to increase NO levels be implemented so as to  increase resistance against COVID-19  and/or treat patients with mild or moderate symptoms? Such  interventions could include breathing through the nose (Courtey 2020) or diets low in arginine but enriched with dietary factors supporting NO formation in the body (Kobayashi 2015, Flam 2007).
Based on the hypotheses presented above, I would like to propose clinical trials among COVID-19 patients of less than severe symptoms.
Petri Pellinen
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Sources :

Courtney 2020.  Immune protective effects of nasal breathing and nitric oxide for coronaviruses - self care potential.  
El-Hattab  2012.  Citrulline and arginine utility in treating nitric oxide deficiency in mitocondrial disorders.
Fay 2017.  Arginine and its effects on viral replication.
Flam 2007.  Endothelic nitric oxide production is tightly coupled to the citrulline-NO cycle.
Kobayashi 2015.  NO-rich diet for lifestyle-related diseases.
Müller  2016.  D,L-lysine acetysalicylate glycine impair coronavirus replication.
Torregrossa  2011.  Nitric oxide and geriatrics: implications in diagnostics and treatment of the elderly.
Tsyi-Yi Peng  2008.  Phosphorylation of the arginine/serine dipeptide-rich motif of severe acute respiratory syndrome coronavirus nucleocapsid protein modulates its multimerization, translation inhibitory activity and cellular localization.
Åkerström  2005.  Nitric oxide inhibits the replication cycle of severe acute respiratory syndrome coronavirus.
Åkerström  2009.  Dual effect of nitric oxide on SARS CoV replication: viral RNA production and palmitoylation of the S protein are affected.