Sigman Scott A, Mokmeli Soheila, Monici Monica, Vetrici Mariana A
Team Physician, UMASS Lowell, Fellow of the World Society of Sports and Exercise Medicine, Fellow of the Royal College of Surgeons in Ireland, Chelmsford, MA, USA.
Training Institute, Canadian Optic and Laser Center, Victoria, BC, Canada.
Am J Case Rep. 2020 Aug 15;21:e926779. doi: 10.12659/AJCR.926779.
BACKGROUND Coronavirus disease 2019 (COVID-19) is associated with lung inflammation and cytokine storm. Photobiomodulation therapy (PBMT) is a safe, non-invasive therapy with significant anti-inflammatory effects. Adjunct PBMT has been employed in treating patients with lung conditions. Human studies and experimental models of respiratory disease suggest PBMT reduces inflammation and promotes lung healing. This is the first time supportive PBMT was used in a severe case of COVID-19 pneumonia. CASE REPORT A 57-year-old African American man with severe COVID-19 received 4 once-daily PBMT sessions by a laser scanner with pulsed 808 nm and super-pulsed 905 nm modes for 28 min. The patient was evaluated before and after treatment via radiological assessment of lung edema (RALE) by CXR, pulmonary severity indices, blood tests, oxygen requirements, and patient questionnaires. Oxygen saturation (SpO₂) increased from 93-94% to 97-100%, while the oxygen requirement decreased from 2-4 L/min to 1 L/min. The RALE score improved from 8 to 5. The Pneumonia Severity Index improved from Class V (142) to Class II (67). Additional pulmonary indices (Brescia-COVID and SMART-COP) both decreased from 4 to 0. CRP normalized from 15.1 to 1.23. The patient reported substantial improvement in the Community-Acquired Pneumonia assessment tool. CONCLUSIONS This report has presented supportive PBMT in a patient with severe COVID-19 pneumonia. Respiratory indices, radiological findings, oxygen requirements, and patient outcomes improved over several days and without need for a ventilator. Future controlled clinical trials are required to evaluate the effects of PBMT on clinical outcomes in patients with COVID-19 pneumonia.
2019冠状病毒病(COVID-19)与肺部炎症和细胞因子风暴有关。光生物调节疗法(PBMT)是一种安全的非侵入性疗法,具有显著的抗炎作用。辅助性PBMT已被用于治疗肺部疾病患者。呼吸系统疾病的人体研究和实验模型表明,PBMT可减轻炎症并促进肺部愈合。这是首次在重症COVID-19肺炎病例中使用支持性PBMT。病例报告:一名57岁的非裔美国男性患有重症COVID-19,通过激光扫描仪以脉冲808 nm和超脉冲905 nm模式每天接受4次PBMT治疗,每次28分钟。通过胸部X光片对肺水肿进行放射学评估(罗音)、肺部严重程度指数、血液检查、氧气需求和患者问卷调查,对患者治疗前后进行评估。血氧饱和度(SpO₂)从93-94%提高到97-100%,而氧气需求从2-4升/分钟降至1升/分钟。罗音评分从8分提高到5分。肺炎严重程度指数从V级(142)改善到II级(67)。其他肺部指数(布雷西亚-COVID和SMART-COP)均从4降至0。C反应蛋白(CRP)从15.1恢复正常至1.23。患者报告社区获得性肺炎评估工具中有显著改善。结论:本报告介绍了在一名重症COVID-19肺炎患者中使用支持性PBMT的情况。呼吸指标、放射学检查结果、氧气需求和患者预后在数天内得到改善,且无需使用呼吸机。未来需要进行对照临床试验,以评估PBMT对COVID-19肺炎患者临床结局的影响。