Efficacy of low-intensity pulsed ultrasound in the treatment of COVID-19 pneumonia

Abstract

Purpose As a public health emergency of international concern, coronavirus disease 2019 (COVID-19) still lacks specific antiviral drugs, and symptomatic treatment is currently the mainstay. The overactivated inflammatory response in COVID-19 patients is associated with a high risk of critical illness or even death. Low-intensity pulsed ultrasound (LIPUS) can mitigate inflammation and inhibit edema formation. We aimed to investigate the efficacy of LIPUS therapy for COVID-19 pneumonia.

Materials and Methods 62 patients were randomly assigned to a treatment group (LIPUS treatment area – Group 1; self-control area – Group 2) and an external control group (Group 3). The primary outcomes were the volume absorption rate (VAR) and the area absorption rate (AAR) of lung inflammation in CT images.

Results After an average duration of treatment 7.2 days, there were significant differences in AAR and VAR between Group 1 and Group 2 (AAR 0.25 vs 0.12, p=0.013; VAR 0.35 vs 0.11, p=0.005), and between Group 1 and Group 3 (AAR 0.25 vs 0.11, p=0.047; VAR 0.35 vs 0.19, p=0.042). Neither AAR nor VAR was statistically different between Group 2 and Group 3. After treatment, C-reactive protein, interleukin-6, leukocyte, and fingertip arterial oxygen saturation (SaO2) improved in Group 1, while in Group 3 only fingertip SaO2 increased.

Conclusion LIPUS therapy reduced lung inflammation and serum inflammatory factor levels in hospitalized COVID-19 patients, which might be a major advancement in COVID-19 pneumonia therapy.

Zusammenfassung

Ziel Für die Coronavirus-Erkrankung (COVID-19), die einen internationalen Gesundheitsnotstand darstellt, gibt es immer noch keine spezifischen antiviralen Medikamente, und die Hauptstütze ist derzeit die symptomatische Behandlung. Die überaktivierte Entzündungsreaktion bei COVID-19-Patienten ist mit einem hohen Risiko für einen schweren Erkrankungsverlauf und Mortalität verbunden. Niedrigenergetischer gepulster Ultraschall (LIPUS) kann die Entzündung lindern und die Ödembildung hemmen. Unser Ziel war es, die Wirksamkeit der LIPUS-Therapie bei COVID-19-Pneumonie zu untersuchen.

Material und Methoden 62 Patienten wurden nach dem Zufallsprinzip einer Behandlungsgruppe (LIPUS-Bereich – Gruppe 1; Selbstkontroll-Bereich – Gruppe 2) und einer externen Kontrollgruppe (Gruppe 3) zugewiesen. Das primäre Outcome waren die Volumenabsorptionsrate (VAR) und die Flächenabsorptionsrate (AAR) der Pneumonie in CT-Aufnahmen.

Ergebnisse Nach einer durchschnittlichen Behandlungsdauer von 7,2 Tagen gab es signifikante Unterschiede bei AAR und VAR zwischen Gruppe 1 und Gruppe 2 (AAR 0,25 vs. 0,12, p=0,013; VAR 0,35 vs. 0,11, p=0,005) sowie zwischen Gruppe 1 und Gruppe 3 (AAR 0,25 vs. 0,11, p=0,047; VAR 0,35 vs. 0,19, p=0,042). Weder AAR noch VAR unterschieden sich statistisch zwischen Gruppe 2 und Gruppe 3. Nach der Behandlung verbesserten sich in Gruppe 1 die Werte für C-reaktives Protein, Interleukin-6, Leukozyten und die arterielle Sauerstoffsättigung (SaO2) an der Fingerspitze, während in Gruppe 3 nur die SaO2 an der Fingerspitze anstieg.

Schlussfolgerung Die LIPUS-Therapie verringerte die Pneumonie und die Konzentration von Entzündungsfaktoren im Serum bei hospitalisierten COVID-19-Patienten, was einen wichtigen Fortschritt in der Therapie der COVID-19-Pneumonie darstellen könnte.

Keywords

COVID-19 - SARS-CoV-2 - Ultrasonic therapy - Low-intensity pulsed ultrasound - viral pneumonia

Publication History

Received: 28 September 2022

Accepted after revision: 13 July 2023

Accepted Manuscript online:
19 July 2023

Article published online:
04 December 2023

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