Photobiomodulation Therapy as a Possible New Approach in COVID-19: A Systematic Review

Abstract

COVID-19 is a viral disease characterized as a pandemic by the World Health Organization in March 2020. Since then, researchers from all over the world have been looking for ways to fight this disease. Many cases of complications arise from insufficient immune responses due to low immunity, with intense release of pro-inflammatory cytokines that can damage the structure of organs such as the lung. Thus, the hypothesis arises that photobiomodulation therapy (PBMT) with the use of a low-level laser (LLLT) may be an ally approach to patients with COVID-19 since it is effective for increasing immunity, helping tissue repair, and reducing pro-inflammatory cytokines. This systematic review was performed with the use of PubMed/MEDLINE, Web of Science, Scopus and Google Scholar databases with the following keywords: “low-level laser therapy OR photobiomodulation therapy AND COVID-19”. The inclusion criteria were complete articles published from January 2020 to January 2021 in English. The exclusion criteria were other languages, editorials, reviews, brief communications, letters to the editor, comments, conference abstracts, and articles that did not provide the full text. The bibliographic search found 18 articles in the Pubmed/MEDLINE database, 118 articles on the Web of Science, 23 articles on Scopus, and 853 articles on Google Scholar. Ten articles were included for qualitative synthesis, of which four commentary articles discussed the pathogenesis and the effect of PBMT in COVID-19. Two in vitro and lab experiments showed the effect of PBMT on prevention of thrombosis and positive results in wound healing during viral infection, using the intravascular irradiation (ILIB) associated with Phthalomethyl D. Two case reports showed PBMT improved the respiratory indexes, radiological findings, and inflammatory markers in severe COVID-19 patients. One case series reported the clinical improvement after PBMT on 14 acute COVID-19 patients, rehabilitation on 24 patients, and as a preventive treatment on 70 people. One clinical trial of 30 patients with severe COVID-19 who require invasive mechanical ventilation, showed PBMT-static magnetic field was not statistically different from placebo for the length of stay in the Intensive Care Unit, but improved diaphragm muscle function and ventilation and decreased the inflammatory markers. This review suggests that PBMT may have a positive role in treatment of COVID-19. Still, the necessity for more clinical trials remains in this field and there is not sufficient research evidence regarding the effects of PBMT and COVID-19 disease, and there is a large gap.

Reduction of Post-Covid Pulmonary Fibrosis and Bronchiectasis by Physiotherapy

“…The multiple effects, proven by in vivo and in vitro studies, of PBM support the application of this therapeutic method both in the acute period of COVID-19 pneumopathy and in the sequelae period to reduce mortality and morbidity, increase the quality of life and socio-professional reintegration of patients. In fact, an analysis of the studies on PMB in COVID pneumopathy, which included 18 studies from the Pubmed/MEDLINE database, an article from the Web of Science; 3 articles from Google Scholar, which were selected according to rigorous criteria, concluded that PBM represents a promising approach in COVID-19 pneumonitis, having a demonstrated anti-inflammatory effect, which can especially counteract lung damage [25]. Pulsatile shortwave therapy uses the electrical component of the alternating highfrequency electromagnetic field (27.12 MHz).…”

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

“…Whilst the exact mechanism by which NIR increases iNOS is unknown, it is established that the resultant NO plays a key role in PBMT that could be utilized in COVID-19 treatment. Due to its ability to reduce platelet activation, and the role of platelet adhesion in thrombosis, NO has further potential to treat thrombosis in COVID-19 patients [95,96].…”

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

“…Another relevant approach is photobiomodulation therapy (PBMT), i.e., the light therapy based on non-ionizing types of light sources such as laser, that could be employed with or without application of a static magnetic field (sMF) [ 135 , 136 ]. Severe cases of COVID-19 arise when immune response in the patient’s body is insufficient and pro-inflammatory cytokines are extensively released and harm different organs such as lungs.…”

“…Severe cases of COVID-19 arise when immune response in the patient’s body is insufficient and pro-inflammatory cytokines are extensively released and harm different organs such as lungs. 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.…”