Photobiomodulation Therapy: A Promising, Evidence-Based Strategy Against COVID-19

Based on the American Journal of Case Reports e-ISSN 1941–5923, © Am J Case Rep, 2020; 21: e926779 DOI: 10.12659/AJCR.926779.

Authors: Scott A. Sigman, Soheila Mokmeli, Monica Monici, Mariana A. Vetrici

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

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COVID-19

Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Typical features include dyspnea, lung edema, and pneumonia. Morbidity and mortality are linked to acute respiratory distress syndrome (ARDS) and cytokine storm. Patients are considered severe if they require intensive care unit (ICU) admission [1,2]. We describe what may be the first use of supportive photobiomodulation therapy (PBMT) in a patient with severe COVID-19 pneumonia.

What is PBMT?

Photobiomodulation Therapy (PBMT) is the technical term for Low-Level Laser Therapy (LLLT). It applies low-intensity laser or LED light to an area to promote tissue repair and lessen pain and inflammation.

PBMT is an emerging option with reported anti-inflammatory effects in pain management, lymphedema, wound healing, and musculoskeletal injuries. Synonyms include low-level laser therapy, cold laser, and photobiostimulation. Unlike high-power surgical lasers that destroy tissue, PBMT is non-invasive, relatively inexpensive, and has no known adverse effects.

Small studies in children, adults, and elderly patients with pneumonia, asthma, chronic bronchitis, or pulmonary fibrosis have noted reduced chest discomfort, easier breathing, shorter recovery, and improved immunological or radiological findings; larger trials are needed.

Case Report

A 57-year-old African American man with hypertension and asthma presented with shortness of breath, severe dehydration, and acute renal failure. Examination revealed labored breathing, weakness, and fatigue. Chest X-rays showed worsening bilateral infiltrates, and he required ICU care for respiratory depression.

SARS-CoV-2 was confirmed by nasopharyngeal RT-PCR. The patient consented to an IRB-approved trial of laser treatment for COVID-19 (Lowell General Hospital Federal-wide Assurance 0001427).

He received treatment with an FDA-cleared Multiwave Locked System (MLS) Therapy Laser (ASA Laser, Italy). The MLS device uses a mobile scanner with two synchronized diodes—one pulsed at 905 nm and one at 808 nm—operating together. This system is routinely used in pain centers for musculoskeletal pain and inflammation.

FDA device information PubMed search

The patient tolerated all four daily treatments and reported noticeably easier breathing immediately after each session. Paroxysmal coughing spells resolved after the third session. Following the fourth treatment, the patient was able to walk in the room with physical therapy. The day after the final treatment, he was discharged to an acute rehabilitation facility on 1 L/min oxygen. The next day, he completed two stair-climbing trials with physical therapy and began weaning toward room air.

The patient’s response to PBMT was assessed by comparing scoring tools before and after laser therapy; improvements were seen in every evaluated domain.

Conclusions

This report describes a patient with severe COVID-19 pneumonia complicated by ARDS who received supportive PBMT. Together with existing clinical experience of PBMT for respiratory conditions, this case suggests the approach may serve as a feasible adjunct for COVID-19 care. Laboratory studies indicate PBMT can exert anti-inflammatory effects on lung tissue, and clinicians propose that early adjunct PBMT might hasten recovery and possibly lessen the need for prolonged ventilation or ICU stay, although larger trials are needed.

PubMed search: PBMT lung inflammation

References:

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Further reading:

• PubMed search for photobiomodulation
• WHO COVID-19 information
• ClinicalTrials.gov

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