Phototherapy as a Rational Antioxidant Treatment Modality in COVID-19 Management; New Concept and Strategic Approach: Critical Review

Abstract

The COVID-19 pandemic has taken the entire globe by storm. The pathogenesis of this virus has shown a cytokine storm release, which contributes to critical or severe multi-organ failure. Currently the ultimate treatment is palliative; however, many modalities have been introduced with effective or minimal outcomes. Meanwhile, enormous efforts are ongoing to produce safe vaccines and therapies. Phototherapy has a wide range of clinical applications against various maladies. This necessitates the exploration of the role of phototherapy, if any, for COVID-19. This critical review was conducted to understand COVID-19 disease and highlights the prevailing facts that link phototherapy utilisation as a potential treatment modality for SARS-CoV-2 viral infection. The results demonstrated phototherapy’s efficacy in regulating cytokines and inflammatory mediators, increasing angiogenesis and enhancing healing in chronic pulmonary inflammatory diseases. In conclusion, this review answered the following research question. Which molecular and cellular mechanisms of action of phototherapy have demonstrated great potential in enhancing the immune response and reducing host–viral interaction in COVID-19 patients? Therefore, phototherapy is a promising treatment modality, which needs to be validated further for COVID-19 by robust and rigorous randomised, double blind, placebo-controlled, clinical trials to evaluate its impartial outcomes and safety.

Whole‐organ transdermal photobiomodulation (PBM) of COVID‐19: A 50‐patient case study

“…PBM is also found to interfere with a pathogen's ability to replicate[ 20 ] through innate immune response (via reactive ion species, [ROS]) and over longer intervals by regulating adaptive immune response. Other light wavelengths can damage pathogens directly,[ 21 ], [ 22 ], [ 23 ] albeit not transdermally in deep tissue or viscera.…”

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

“…These studies found blue and violet light effects such as virus inactivation, including coronavirus and the common flu virus, and antimicrobial effect. These effects can be used, respectively, for cleaning, avoiding contagion by a coronavirus from infected surfaces, and mitigating opportunistic bacteria in the treatment of COVID-19 [ 29 , 40 , 41 ]. In addition, therapeutic effects of red and infrared light have also been found effective in treating various diseases such as pneumonia, decreasing inflammation, pulmonary edema, and fibrosis in the lung.…”

“…Continuous irradiation at different points in the respiratory system can be helpful in the treatment of COVID-19 pneumonia. PBMT can be used as a preventive approach in high-risk, elderly, or comorbid patients receiving pre-treatment PBMT while still at an early stage of the disease [ 40 ]. In addition, PBMT can be considered a therapeutic approach in hospitalized patients before their condition worsens enough to require ICU admission [ 44 ].…”

Understanding COVID-19 Pandemic: Molecular Mechanisms and Potential Therapeutic Strategies. An Evidence-Based Review

“…This coincides with a recent critical review by Hanna et al, showed that phototherapy is a promising treatment modality in COVID-19 pandemic that demands to be validated by robust and rigorous randomized, double blind, placebo-controlled, clinical trials to evaluate its impartial outcomes and safety. 234 Taking into consideration the abovementioned potential of phototherapy in COVID-19 management, at this stage only four RCTs have been registered at clinicaltrials.gov, which are either in the recruiting phase or not recruiting yet or completed phase without reported results (Table 4). These trials are highlighted below.…”