Effects of Photobiomodulation Therapy Combined with Static Magnetic Field in Severe COVID-19 Patients Requiring Intubation: A Pragmatic Randomized Placebo-Controlled Trial

Abstract

Purpose: We aimed to investigate the effects of photobiomodulation therapy combined with static magnetic field (PBMT-sMF) on the length of intensive care unit (ICU) stay and mortality rate of severe COVID-19 patients requiring invasive mechanical ventilation and assess its role in preserving respiratory muscles and modulating inflammatory processes. Patients and Methods: We conducted a prospectively registered, triple-blinded, randomized, placebo-controlled trial of PBMT-sMF in severe COVID-19 ICU patients requiring invasive mechanical ventilation. Patients were randomly assigned to receive either PBMT-sMF or a placebo daily throughout their ICU stay. The primary outcome was length of ICU stay, defined by either discharge or death. The secondary outcomes were survival rate, diaphragm muscle function, and the changes in blood parameters, ventilatory parameters, and arterial blood gases. Results: Thirty patients were included and equally randomized into the two groups. There were no significant differences in the length of ICU stay (mean difference, MD = −6.80; 95% CI = −18.71 to 5.11) between the groups. Among the secondary outcomes, significant differences were observed in diaphragm thickness, fraction of inspired oxygen, partial pressure of oxygen/fraction of inspired oxygen ratio, C-reactive protein levels, lymphocyte count, and hemoglobin (p < 0.05). Conclusion: Among severe COVID-19 patients requiring invasive mechanical ventilation, the length of ICU stay was not significantly different between the PBMT-sMF and placebo groups. In contrast, PBMT-sMF was significantly associated with reduced diaphragm atrophy, improved ventilatory parameters and lymphocyte count, and decreased C-reactive protein levels and hemoglobin count. Trial Registration Number (Clinical Trials.gov): NCT04386694.

Can Photobiomodulation Therapy (PBMT) Minimize Exercise-Induced Oxidative Stress? A Systematic Review and Meta-Analysis

“…On the other hand, current studies demonstrate that PBMT can be an important tool in preventing muscle fatigue, improving performance, and also decreasing atrophy [ 63 , 64 ]. In a recently published study by our research group, we observed clinical improvement and decreased diaphragmatic muscle atrophy in ICU intubated patients when they received a daily application of PBMT [ 16 ]. Therefore, studies that investigate these effects in fatigue-related pathologies, such as chronic fatigue syndrome and LONG-COVID-19, and others, are warranted.…”

“…Recently, among the various resources researched to reduce the harmful effects of exercise, low-level laser therapy, also called photobiomodulation therapy (PBMT), has gained prominence [ 16 ]. The PBMT is defined as a form of light therapy that uses non-ionizing light sources, including lasers, light-emitting diodes and/or broadband light, in the visible (400–700 nm) and near-infrared (700–1100 nm) electromagnetic spectrum [ 17 , 18 ].…”

Rationale for 1068 nm Photobiomodulation Therapy (PBMT) as a Novel, Non-Invasive Treatment for COVID-19 and Other Coronaviruses: Roles of NO and Hsp70

“…This suggests that PBMT could be used to improve COVID-19 patients' respiratory and clinical conditions, decreasing the requirement for ventilator support and ICU stay. Similarly, a placebo-controlled trial of thirty severe COVID-19 patients found that, whilst the length of ICU stay did not change between groups, patients treated with 905/633/850 nm PBMT-sMF (PBMT combined with static magnetic field) showed reduced diaphragm atrophy and improved ventilatory parameters and lymphocyte count [82]. A case report by Sigman et al (2020) used a combination of 808 and 905 nm PBM to treat a 57-year-old man with a severe case of COVID-19 pneumonia.…”

Biomedical Applications of Antiviral Nanohybrid Materials Relating to the COVID-19 Pandemic and Other Viral Crises

“…As a supportive therapeutic strategy, PBMT utilizing a low-level laser (LLLT) raises immunity, stimulate tissue regeneration and decline pro-inflammatory cytokines [ 135 ]. De Marchi et al [ 137 ] studied the treatment of the patients suffering from severe COVID-19, who were in the need of mechanical ventilation, through PBMT-sMF. As they reported, PBMT-sMF could enhance the ventilatory parameters and improve the immune response.…”