Low-dose Whole-lung Irradiation for COVID-19 Pneumonia: Short Course Results

Ameri, Ali; Rahnama, Nazanin; Bozorgmehr, Rama; Mokhtari, Majid; Farahbakhsh, Mohammad; Nabavi, Mahmood; Shoaei, Simin Dokht; Izadi, Hossein; Kashi, Amir Shahram Yousefi; Dehbaneh, Hadiseh Shabanpour; Taghizadeh‐Hesary, Farzad

doi:10.21203/rs.3.rs-40507/v1

Cited by 21 publications

(31 citation statements)

References 12 publications

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“…Other authors have thoroughly reviewed the rationale for radiotherapy in COVID-19 [108,109]. Preliminary reports have found that low-dose radiotherapy is safe for patients with COVID-19 and could be a useful therapeutic modality [110,111]. The combination of mild hyperthermia with low-dose radiotherapy could be a potentially beneficial therapy for patients with COVID-19.…”

Section: Thermotherapy Plus Radiotherapy In Covid-19mentioning

confidence: 99%

Exploring the rationale for thermotherapy in COVID-19

Mancilla-Galindo

Galindo-Sevilla

2021

International Journal of Hyperthermia

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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.

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Section: Thermotherapy Plus Radiotherapy In Covid-19mentioning

confidence: 99%

Exploring the rationale for thermotherapy in COVID-19

Mancilla-Galindo

Galindo-Sevilla

2021

International Journal of Hyperthermia

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“…A second pilot study included 5 severe phase COVID-19 patients (median age 69), without matched controls. 50 These patients were hospitalized, demonstrated radiographic consolidations, and required supplemental oxygen. All 5 patients were treated with a single-dose LD-RT, 0.5 Gy, and were followed for 5-7 days to evaluate treatment response, clinical outcomes, and potential toxicity.…”

Section: Recent Clinical Trials Using Ld-rt For Severe Covid-19mentioning

confidence: 99%

Immunomodulation Through Low-Dose Radiation for Severe COVID-19: Lessons From the Past and New Developments

et al. 2020

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Low-dose radiation therapy (LD-RT) has historically been a successful treatment for pneumonia and is clinically established as an immunomodulating therapy for inflammatory diseases. The ongoing COVID-19 pandemic has elicited renewed scientific interest in LD-RT and multiple small clinical trials have recently corroborated the historical LD-RT findings and demonstrated preliminary efficacy and immunomodulation for the treatment of severe COVID-19 pneumonia. The present review explicates archival medical research data of LD-RT and attempts to translate this into modernized evidence, relevant for the COVID-19 crisis. Additionally, we explore the putative mechanisms of LD-RT immunomodulation, revealing specific downregulation of proinflammatory cytokines that are integral to the development of the COVID-19 cytokine storm induced hyperinflammatory state. Radiation exposure in LD-RT is minimal compared to radiotherapy dosing standards in oncology care and direct toxicity and long-term risk for secondary disease are expected to be low. The recent clinical trials investigating LD-RT for COVID-19 confirm initial treatment safety. Based on our findings we conclude that LD-RT could be an important treatment option for COVID-19 patients that are likely to progress to severity. We advocate the further use of LD-RT in carefully monitored experimental environments to validate its effectiveness, risks and mechanisms of LD-RT.

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“…25 Preliminary results from a clinical trial in Iran on 5 patients indicated this therapy may be as effective as it was in the 1940s against viral pneumonia. 26 It is important to note that 40 dying patients were invited to participate, but only 5 agreed. The other 35 chose to risk death rather than accept the perceived risk of a low dose of radiation.…”

mentioning

confidence: 99%

The LNT Issue Is About Politics and Economics, Not Safety

Cuttler¹

2020

Dose-Response

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The Sykes commentary advocates “a more sensible, graded approach for protection from low dose ionizing radiation” until the LNT dose-response issue is resolved. It urges scientists to stop criticizing the LNT model that links radiation to a risk of cancer and accept regulatory use of the threshold model to “protect” people, but with higher limits. It fails to mention the 120-year history of successful low-dose treatments of a wide variety of serious diseases, including cancers. The commentary ignores published evidence of a threshold at 1.1 Gy for radiogenic leukemia and a dose-rate threshold at about 0.6 Gy per year for lifespan shortening. LNT came from politicized science, replete with scientific misconduct and conflict of interest. Its acceptance created a false cancer scare that was likely intended to stop atomic bomb testing, but it has severely damaged human welfare. Many vitally important low-dose therapies were discarded when the radiation scare was disseminated in 1956. The rapid growth of nuclear energy ended with the media-inflamed public panic after the Three Mile Island accident in 1979. Extreme implementation of the precautionary principle made it uneconomic. Availability of a low-dose therapy for lung inflammation could have dramatically decreased the impact of the COVID-19 pandemic.

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Low-dose Whole-lung Irradiation for COVID-19 Pneumonia: Short Course Results

Cited by 21 publications

References 12 publications

Exploring the rationale for thermotherapy in COVID-19

Exploring the rationale for thermotherapy in COVID-19

Immunomodulation Through Low-Dose Radiation for Severe COVID-19: Lessons From the Past and New Developments

The LNT Issue Is About Politics and Economics, Not Safety

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