Low-Dose Lung Radiation Therapy Improves Outcomes in Patients with COVID-19 Pneumonia

Respiratory decline in COVID-19 is mediated by a pneumonic aberrant immune cytokine storm. In the pre-antibiotic era, low-dose radiation was used to treat pneumonia and it has been suggested that radiation immunomodulatory effects can improve outcomes in COVID-19.

Doctors at the Emory University (Atlanta, GA, USA) performed a single-institution Phase 1/2 trial evaluating the safety and efficacy of single-fraction, low-dose, whole-lung radiation for COVID-19 pneumonia. Eligible patients were hospitalized, had radiographic pneumonic infiltrates, required supplemental oxygen, and were clinically deteriorating. In the pilot trial of five oxygen-dependent patients with COVID-19 pneumonia, three patients weaned from supplemental oxygen to ambient air within 24 hours of radiation, four exhibited radiographic improvement, and their median Glasgow coma score improved from 10 to 14. A fourth patient weaned from oxygen after 96 hours. The mean time to clinical recovery was 35 hours and the doctors did not find any acute skin, pulmonary, GI, and GU toxicities.

The doctors have concluded that low-dose whole-lung radiation is safe, shows early promise of efficacy, and warrants further study in larger prospective trials.

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Emory University