Exploring the rationale for thermotherapy in COVID-19

Abstract

Increased transmissibility of the pandemic severe acute respiratory coronavirus 2 (SARS-CoV-2) has been noted to occur at lower ambient temperatures. This is seemingly related to a better replication of most respiratory viruses, including SARS-CoV-2, at lower-than-core body temperatures (i.e., 33 C vs 37 C). Also, intrinsic characteristics of SARS-CoV-2 make it a heat-susceptible pathogen. Thermotherapy has successfully been used to combat viral infections in plants which could otherwise result in great economic losses; 90% of viruses causing infections in plants are positive-sense singlestranded ribonucleic acid (þssRNA) viruses, a characteristic shared by SARS-CoV-2. Thus, it is possible to envision the use of heat-based interventions (thermotherapy or mild-temperature hyperthermia) in patients with COVID-19 for which moderate cycles (every 8-12 h) of mild-temperature hyperthermia (1-2 h) have been proposed. However, there are potential safety and mechanistic concerns which could limit the use of thermotherapy only to patients with mild-to-moderate COVID-19 to prevent disease progression rather than to treat patients who have already progressed to severe-to-critical COVID-19. Here, we review the characteristics of SARS-CoV-2 which make it a heat-susceptible virus, potential host mechanisms which could be enhanced at higher temperatures to aid viral clearance, and how thermotherapy could be investigated as a modality of treatment in patients with COVID-19 while taking into consideration potential risks.

Hyperthermia ablation combined with transarterial chemoembolization versus monotherapy for hepatocellular carcinoma: A systematic review and meta‐analysis

“…Mancilla-Galindo et al 26 presented a novel idea of mild hyperthermia (thermotherapy) as a potential therapy for patients with mild-to-moderate COVID-19 to prevent disease progression. Hyperthermia therapy (including HA) could improve the immunity of cancer patients, [23][24][25][26][27][28][29][30][31][32][33]83,84 which should be given adequate attention to for the anticancer treatment in the context of COVID-19 crisis. [8][9][10][11][12][13][14]26 The need of minimal invasion has already become a crucial consideration for therapeutic decision-making in the SAUCCC.…”

“…Hyperthermia therapy (including HA) could improve the immunity of cancer patients, [23][24][25][26][27][28][29][30][31][32][33]83,84 which should be given adequate attention to for the anticancer treatment in the context of COVID-19 crisis. [8][9][10][11][12][13][14]26 The need of minimal invasion has already become a crucial consideration for therapeutic decision-making in the SAUCCC. [8][9][10][11][12][13][14] Accordingly, HA and HATACE possess unique superiorities among multifarious therapies for appropriate HCC patients in the SAUCCC, [17][18][19][20][22][23][24][25][26][27][28][29][30][31][32][33][85][86][87]…”

“…[8][9][10][11][12][13][14]26 The need of minimal invasion has already become a crucial consideration for therapeutic decision-making in the SAUCCC. [8][9][10][11][12][13][14] Accordingly, HA and HATACE possess unique superiorities among multifarious therapies for appropriate HCC patients in the SAUCCC, [17][18][19][20][22][23][24][25][26][27][28][29][30][31][32][33][85][86][87][88] which is fully exhibited in the Data S1. COVID-19 throughout the world has caused unprecedented social turmoil on a global level, triggering F I G U R E 3 Risk of bias summary before correction: each risk of bias item for each RCT of sensitivity analysis.…”

On the Possibility of a Microwave Approach for Rooms and Objects Sterilization

“…Indeed, the entire problem is quite simple to be solved. In fact, it is enough a thermometer in order to perform an on line and real time measurement of the temperature inside the room [20][21][22][23][24][25][26][27][28][29][30][31][32][33]. This means that the correct exposure time can be easily adapted according to specific case.…”

“…In a nutshell, the critical point is represented by the working temperature, which should be high to reduce the infection, but also low enough to avoid any tissue damage. After verifying if this condition is fulfilled, a very precise temperature control of the inner tissues is required in order to avoid any negative collateral effect [1,[22][23][24][25][26][27][28][29][30][31][32][33]. Taking advantage on the strong absorption from the human tissues of the microwave radiation centered around 2.15GHz, it seems reasonable to use this radiation to induce a well-controlled hyperthermia to decrease the virus strength.…”