As coronavirus rapidly affects millions worldwide, scientists and physicians have been trying multiple treatments to alleviate severe cases. Treatments such as anti-malaria, anti-inflammation, and several others have been used due to the severe lack of proper medical services such as ventilation machines.

One new proposed treatment is radiation, specifically low dose radiation therapy (LDRT) for pneumonia. LDRT was used to treat pneumonia during the early 20th century. Studies from that time resulted in reduced mortality rates.

Low doses of X-rays suppress inflammatory responses. This could be useful treatments for coronavirus patients experiencing a cytokine storm or when the body has an extreme inflammatory systematic response that results in acute respiratory distress syndrome.

Considering Low Dose Radiation Therapy

To reduce the high mortality rate of coronavirus, researchers are focusing on treating pneumonia or reducing the cytokine storm. Previous treatments that physicians have tried include the anti-malaria drug hydroxychloroquine and remdesivir, which was recently approved by the U.S. Food and Drug Administration.

LDRT has been applied for other illnesses such as cancer, rheumatoid arthritis, and other autoimmune inflammatory diseases. Edward Calabrese from the University of Massachusetts wrote that one possible way X-ray therapy "mitigates inflammation and facilitates healing is via the polarization of macrophages to an anti-inflammatory or M2 phenotype."

Other studies have shown how LDRT regulates lymphocyte levels, controls bacterial infections, and reduce excess inflammatory responses. Some Covid-19 patients with severe cases have severe inflammation not only in the lungs but in other major organs as well.

The radiation treatment proved to be effective for patients with viral pneumonia who did not respond to sulfonamide drug treatments. Sulfonamides are synthetic drugs that contain sulfur and are typically in the form of antibiotics.

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Outdated Clinical Studies

However, researchers from the Isfahan University of Medical Sciences in Iran stated the possible risks of using low doses of radiation to treat Covid-19 patients. For example, LDRT publications of effective pneumonia treatment "are too old and haven't been established with satisfactory scientific reliability." There was also a lack of animal trials and the patients involved in 20th-century studies were not compared to today's randomized clinical trial methods.

Moreover, anti-inflammatory drugs affect the whole body while X-ray treatment can specifically target the lungs or places of inflammation. The low doses of radiation result in severe health risks either.

In another study, Seyed Mortazavi from the Shiraz University of Medical Sciences and his team proposed treating Covid-19 patients with a single dose between 100 and 250 mGy X-ray radiation. This treatment would also stop the virus from mutating into a more antibiotic-resistant form.

Dr. Amirhosein Kefayat, who is against LDRT treatment, said that despite the abundance of anti-inflammatory drugs, none have proved to be effective for cytokine storm management in infectious diseases. Some patients have even experienced worsening conditions after such treatment.

In general, there needs to be more clinical studies on the efficacy of LDRT for Covid-19 patients. Mortazavi said, "we consider low‐dose irradiation to be worth investigating in the clinical setting."

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