ABSTRACT
BACKGROUND AND PURPOSE: The main cause of death in COVID-19 pneumonia is acute respiratory distress syndrome which is preceded by massive cytokine release. Low-dose radiation therapy (LDRT) has anti-inflammatory and immunomodulatory effects that can interfere with the inflammatory cascade, reducing the severity of associated cytokine release. MATERIAL & METHODS: 25 patients with RT-PCR proven COVID-19 pneumonia were enrolled between November 2020 and May 2021. All patients had SpO2â¯<â¯94â¯% on room air, respiratory frequencyâ¯>â¯24/min and SpO2/FiO2 ratio (SF ratio) of >89 but <357. Patients were treated according to standard COVID-19 management guidelines along with single fraction LDRT of 0.5â¯Gy to bilateral whole lungs within 10â¯days of symptom onset and 5â¯days of hospital admission. RESULTS: LDRT was well tolerated by all patients. There was a statistically significant improvement in oxygenation as given by the SF ratio between pre-RT and day 2 (pâ¯<â¯0.05), day 3 (pâ¯<â¯0.001) and day 7 (pâ¯<â¯0.001) post RT. Demand for supplemental oxygen showed statistically significant reduction between pre-RT and day 2 (pâ¯<â¯0.05), day 3 (pâ¯<â¯0.001), day 7 (pâ¯<â¯0.001) post RT. 88â¯% patients attained clinical recovery within 10â¯days post LDRT and median time to hospital discharge from day of LDRT was 6â¯days. Three patients deteriorated and died. CONCLUSION: As per our initial experience, LDRT appears to be a promising modality of treatment with rapid relief of respiratory distress in selected patients with moderate to severe COVID-19 pneumonia. This translates to early clinical recovery and hospital discharge in the selected patient group.