There is exciting new information to suggest that low-dose radiation may be an effective treatment modality in severely ill COVID-19 patients. A research team at Emory University Hospital in Atlanta conducted a small scale trial on seriously ill COVID-19 patients. They studied five oxygen-dependent COVID-19 patients with severe pneumonia who appeared to be deteriorating. The average age of the five patients was 90 yrs and the youngest of them was 64. Four of the patients were African-American and would therefore be considered high risk in addition to their age. Each patient was given a single, low-dose of radiation measuring 1.5 Gray to both lungs. The gray is a dose unit of ionizing radiation defined as the absorption of one joule of radiation energy per kilogram of matter. It replaces the older unit of radiation known as the “rad” (one gray = 100 rads). The entire treatment took less than fifteen minutes. Amazingly four of the patients showed improvement in mental status and oxygen levels within twenty-four hours. The patients recovered and were released from the hospital twelve days later. Followup blood tests and chest x-rays did not suggest any adverse effects from the radiotherapy. None of the patients experienced any gastrointestinal or genitourinary side effects that are often seen when external radiation is administered. The results of this limited study were published in a non-peer-reviewed journal in an effort to get the information out for further study as a potential therapeutic option, particularly in advanced stages of the disease.
We know that COVID-19 triggers an overly aggressive immune response which has been referred to as a “cytokine storm.” The uncontrolled inflammatory response damages the alveolar membranes producing the often deadly acute respiratory distress syndrome (ARDS). It is critical to treat patients successfully before they reach this stage when the mortality rate increases dramatically, particularly in elderly patients. Radiation therapy is believed to exert anti-inflammatory effects in the lungs, altering macrophages and averting the often deadly cytokine storm. This trial is especially exciting because it suggests a therapy that is effective in treating elderly patients in whom mortality rates are significantly higher. Mortality rates for patients over age 80 are approximately 15%. If that 80 yr old patient is admitted to ICU their mortality rate increases to 50%. Most hospitals are equipped to administer radiation therapy and no additional equipment or training will be required to begin treatment in COVID-19 patients. Numerous larger clinical trials utilizing low-dose radiation have begun in the U.S. and in other countries. Low-dose radiation may not have any anti-viral effects but the ability to block the hyperimmune response alone could be life-saving.