COVID-19 pneumonia treated with ultra-low doses of radiotherapy (ULTRA-COVID study): a single institution report of two cases

Abstract

Introduction Since the outbreak of coronavirus disease 2019 (COVID-19) pandemic, healthcare systems have focused their efforts into finding a treatment to avoid the fatal outcomes of severe acute respiratory syndrome due to coronavirus-2 (SARS-CoV-2). Benefits and risks of systemic treatments remain unclear, with multiple clinical trials still ongoing. Radiotherapy could play a role in reducing the inflammatory response in the lungs and relieve life-threatening symptoms. Methods We designed a prospective study of Ultra-Low Doses of Therapy with Radiation Applied to COVID-19 (ULTRA-COVID) for patients who suffer pneumonia, are not candidates for invasive mechanical ventilation and show no improvement with medical therapy. Results We present the preliminary results of two patients diagnosed with COVID-19 pneumonia treated with ULTRA-COVID. After one radiotherapy session, significant clinical response and a good radiological response was observed in both cases, resulting in both patients being discharged from hospital in less than 2 weeks after radiation treatment. Conclusion Preliminary clinical and radiological results suggest a potential benefit of treating COVID-19 pneumonia with ULTRA-COVID. ClinicalTrials.gov Identifier: NCT04394182

Could pulmonary low-dose radiation therapy be an alternative treatment for patients with COVID-19 pneumonia? Preliminary results of a multicenter SEOR-GICOR nonrandomized prospective trial (IPACOVID trial)

“…Both patients experienced clinical improvement after LD-RT according to the increase in PaO 2 /FiO 2 ratio above 300 mm Hg as well as reduced dyspnea, asthenia and bilateral pulmonary infiltrative pattern, visible in the chest CT. In addition, the authors also report a decrease in inflammatory parameters, especially IL‑6 levels [ 26 ]. Del Castillo et al.…”

Low-Dose Radiation Therapy for COVID-19: A Systematic Review

“…Furthermore, delivering radiation therapy to hypoxic COVID-19 patients, who may have ARDS, could increase the risk of infection to staff and other patients if not enough safety measures are taken. However, current data indicate that the cancer risk associated with LDRT is scarce [28,40,41]. LDRT can affect the lung macrophages significantly at 0.5 and 1 Gy radiation doses.…”

“…In Figure 2, the sample sizes of the 9 clinical trials reviewed in this study are shown. The highest number of samples in any of the trials was 36 patients (Arenas et al [27]), while the lowest number of samples was only 2 (Moreno et al [28]). was 36 patients (Arenas et al [27]), while the lowest number of samples was only 2 (Moreno et al [28]).…”

“…In the 9 clinical trials finally reviewed in detail in this study, patients received a single fraction of radiation to the lungs at doses between 0.5 and 1.5 Gy. The radiation dose was delivered via an anterior-posterior beam configuration in all these trials [26][27][28][29][30][31][32][33][34][35]). The highest dose was 1.5 Gy [32,33], and the lowest dose was 0.5 Gy [26,29,30].…”

Burden, Depression, and Awareness of Information on Safety Behavior in Korean Hemodialysis Patients during the COVID-19 Pandemic

“…Most of the current studies related to COVID-19 have focused on epidemiology [ 20 ], the clinical course of the disease [ 21 ], the development and efficacy of vaccines [ 22 ], and infection control guidelines [ 23 ]. Some studies have reported psychological problems such as depression, anxiety, and fear, and have focused on the general public and on patients with autoimmune disease, cancer, and chronic disease [ 9 , 24 , 25 , 26 ].…”