Evaluation of Adjunctive Photobiomodulation (PBMT) for COVID-19 Pneumonia via Clinical Status and Pulmonary Severity Indices in a Preliminary Trial

Abstract

Evidence-based and effective treatments for COVID-19 are limited, and a new wave of infections and deaths calls for novel, easily implemented treatment strategies. Photobiomodulation therapy (PBMT) is a well-known adjunctive treatment for pain management, wound healing, lymphedema, and cellulitis. PBMT uses light to start a cascade of photochemical reactions that lead to local and systemic anti-inflammatory effects at multiple levels and that stimulate healing. Numerous empirical studies of PBMT for patients with pulmonary disease such as pneumonia, COPD and asthma suggest that PBMT is a safe and effective adjunctive treatment. Recent systematic reviews suggest that PBMT may be applied to target lung tissue in COVID-19 patients. In this preliminary study, we evaluated the effect of adjunctive PBMT on COVID-19 pneumonia and patient clinical status. Patients and Methods: We present a small-scale clinical trial with 10 patients randomized to standard medical care or standard medical care plus adjunctive PBMT. The PBMT group received four daily sessions of near-infrared light treatment targeting the lung tissue via a Multiwave Locked System (MLS) laser. Patient outcomes were measured via blood work, chest x-rays, pulse oximetry and validated scoring tools for pneumonia. Results: PBMT patients showed improvement on pulmonary indices such as SMART-COP, BCRSS, RALE, and CAP (Community-Acquired Pneumonia questionnaire). PBMT-treated patients showed rapid recovery, did not require ICU admission or mechanical ventilation, and reported no long-term sequelae at 5 months after treatment. In the control group, 60% of patients were admitted to the ICU for mechanical ventilation. The control group had an overall mortality of 40%. At a 5-month follow-up, 40% of the control group experienced long-term sequelae. Conclusion: PBMT is a safe and effective potential treatment for COVID-19 pneumonia and improves clinical status in COVID-19 pneumonia.

Influence of photobiomodulation therapy on the treatment of pulmonary inflammatory conditions and its impact on COVID-19

“…The lung injury in all samples was assessed and compared according to the American Thoracic Socity [ 21 ]. Sample was assessed on a scale of 0–2 for each of the following criteria: (A) neutrophil in the alveolar space, (B) neutrophil in the interstitial space, (C) hyaline membranes, (D) proteinaceous debris filling the airspaces, and (e) alveolar septal thickening.…”

“…Among the resources studied, photobiomodulation therapy (PBMT) with low-intensity laser and light-emitting diodes (LEDs), has been identified as a promising tool for the treatment of inflammatory lung diseases [ 14 – 21 ]. The effects of PBMT are based on the absorption of light photons by cytochrome c oxidase in cell mitochondria, causing a photochemical cascade stimulus that increases the production of reactive oxygen species (ROS), adenosine triphosphate (ATP), and induction of factors of transcription, responsible for regulating the cell cycle, protein synthesis, and important enzymes [ 21 ].…”

“…Among the resources studied, photobiomodulation therapy (PBMT) with low-intensity laser and light-emitting diodes (LEDs), has been identified as a promising tool for the treatment of inflammatory lung diseases [ 14 – 21 ]. The effects of PBMT are based on the absorption of light photons by cytochrome c oxidase in cell mitochondria, causing a photochemical cascade stimulus that increases the production of reactive oxygen species (ROS), adenosine triphosphate (ATP), and induction of factors of transcription, responsible for regulating the cell cycle, protein synthesis, and important enzymes [ 21 ]. Experimental data showed that PBMT with low-intensity laser (mainly with red spectrum light) is able to reduce airway edema, pulmonary inflammation, acute respiratory disorders, pulmonary fibrosis, and other respiratory complications, by decreasing the migration of neutrophils to the lung tissue and reducing the synthesis of pro-inflammatory cytokines (IL-1β, IL-6, TNF-α) and collagen deposition [ 14 , 22 – 26 ].…”

“…According to the results found, low-level laser is considered a promising strategy for the treatment of ALI/ARDS, which represents a major advance for public health in the current world scenario, since ALI/ARDS is one of the main complications caused by COVID-19 infection [ 4 , 21 ].…”

Probiotics, Photobiomodulation, and Disease Management: Controversies and Challenges

“…Table 5 shows the effects of PBM in the action on probiotics [ 307 ], followed by a series of experimental animal studies [ 266 , 288 , 289 , 308 , 309 ], in vitro and/or in vivo cellular models [ 291 , 310 , 311 , 312 ], including the latest clinical trials in patients with COVID-19 [ 313 , 314 ], which demonstrates the perspective applications of PBM for the targeting and modulation of the microbiome [ 266 , 270 , 308 , 309 ], with also the enrichment of the functional genes [ 308 ], the immune system [ 268 , 270 , 288 ], the auxiliary control of chronic degenerative diseases and viral infections [ 310 , 312 , 313 , 314 ], as a challenge for future research in the 21st century (see also Figure 1 ).…”