Bevelacqua Joseph John, Ghadimi-Moghadam Abdolkarim, Mortazavi Seyed Alireza, Jafarzadeh Abdollah, Haghani Masoud, Kaveh-Ahangar Azim, Ghadimi-Moghadam Ali
Bevelacqua Resources, Richland, WA, United States.
Pediatric Infectious Ward, Yasuj University of Medical Sciences, Yasuj, Iran.
J Biomed Phys Eng. 2024 Dec 1;14(6):599-606. doi: 10.31661/jbpe.v0i0.2206-1514. eCollection 2024 Dec.
During the early days of the COVID-19 pandemic, low dose radiation therapy (LDRT) was proposed as a potentially effective treatment method. To minimize potential toxicity, the initial treatment approach involved a few mGy of adapting radiation followed by a single 250 mGy whole lung challenging dose. However, antiviral drugs were also introduced as a promising treatment option, which were thought to have the potential to revolutionize the management of the crisis. Despite early warnings, many physicians did not fully consider the key point that, in contrast with LDRT, antiviral drug treatments can result in strong selective pressure on the virus. This can lead to the emergence of new SARS-CoV-2 variants, a phenomenon that can have serious global consequences. After more than two years, the truth has been revealed the WHO Guideline Development Group has advised against the use of remdesivir, a widely used antiviral medication, for COVID-19. Meanwhile, a growing body of evidence suggests that LDRT can be a promising, low-risk approach for avoiding or delaying invasive respiratory support in COVID-19 patients. Although there is substantial supporting documentation, more high-quality, controlled, and randomized double-blind clinical trials are needed to further investigate the efficacy and potential therapeutic mechanisms of LDRT for COVID-19.
在新冠疫情初期,低剂量放射治疗(LDRT)被提议作为一种潜在的有效治疗方法。为了将潜在毒性降至最低,最初的治疗方法包括先进行几次mGy的适应性放疗,然后给予单次250 mGy的全肺挑战性剂量。然而,抗病毒药物也作为一种有前景的治疗选择被引入,人们认为其有可能彻底改变这场危机的应对方式。尽管有早期警告,但许多医生并未充分考虑到这一关键点,即与LDRT不同,抗病毒药物治疗会对病毒产生强大的选择压力。这可能导致新的新冠病毒变种出现,这种现象可能会产生严重的全球后果。两年多后,真相大白:世界卫生组织指南制定小组已建议不要将广泛使用的抗病毒药物瑞德西韦用于治疗新冠。与此同时,越来越多的证据表明,LDRT对于避免或延迟新冠患者进行有创呼吸支持可能是一种有前景的低风险方法。尽管有大量的支持性文献,但仍需要更多高质量、对照且随机的双盲临床试验来进一步研究LDRT对新冠的疗效和潜在治疗机制。