COVID-19-Associated Pneumonia: Radiobiological Insights

Abstract

The evolution of SARS-CoV-2 pneumonia to acute respiratory distress syndrome is linked to a virus-induced “cytokine storm”, associated with systemic inflammation, coagulopathies, endothelial damage, thrombo-inflammation, immune system deregulation and disruption of angiotensin converting enzyme signaling pathways. To date, the most promising therapeutic approaches in COVID-19 pandemic are linked to the development of vaccines. However, the fight against COVID-19 pandemic in the short and mid-term cannot only rely on vaccines strategies, in particular given the growing proportion of more contagious and more lethal variants among exposed population (the English, South African and Brazilian variants). As long as collective immunity is still not acquired, some patients will have severe forms of the disease. Therapeutic perspectives also rely on the implementation of strategies for the prevention of secondary complications resulting from vascular endothelial damage and from immune system deregulation, which contributes to acute respiratory distress and potentially to long term irreversible tissue damage. While the anti-inflammatory effects of low dose irradiation have been exploited for a long time in the clinics, few recent physiopathological and experimental data suggested the possibility to modulate the inflammatory storm related to COVID-19 pulmonary infection by exposing patients to ionizing radiation at very low doses. Despite level of evidence is only preliminary, these preclinical findings open therapeutic perspectives and are discussed in this article.

Charlson comorbidity index and the severity of community-acquired pneumonia caused by SARS-CoV-2: A retrospective analysis

“…12 One of the hallmarks of SARS-CoV-2 pneumonia evolving to ARDS, which further disrupts ACE signaling pathways, is a cytokine storm that leads to systemic inflammation, coagulation disorders, endothelial damage, and the dysregulation of the immune system. 13 Old age and comorbidities are the main risk factors for the development of pneumonia and ARDS in COVID-19 patients. [14][15][16][17] Physiological changes and diseases affecting metabolism and/or immunity also may aggravate the course of SARS-CoV-2 infection.…”

STAT6/VDR Axis Mitigates Lung Inflammatory Injury by Promoting Nrf2 Signaling Pathway

“…This disease has diverse pathogenic factors, such as environmental pollutants (particulate matter (<2.5microns in aerodynamic diameter)), drug side effects, and viral or fungal infection [ 3 – 5 ]. Uncontrolled inflammation is reportedly one of the determinants that induce thoracic complication in patients with coronavirus disease 2019 [ 6 ]. Recently, the incidence of lung inflammatory injury has sharply increased, but effective therapeutic strategies for this disease are limited.…”