Cardiopulmonary and hematological effects of infrared LED photobiomodulation in the treatment of SARS-COV2.

BACKGROUND: COVID-19 disease is caused by SARS-CoV-2 which can trigger acute respiratory syndrome, which presents with dense alveolar and interstitial infiltrates and pulmonary edema, causing severe hypoxemia and significant alteration to pulmonary mechanics with reduced pulmonary compliance. The photobiomodulation technique alters cellular and molecular metabolism, showing promising results regarding the reduction of acute pulmonary inflammation. OBJECTIVE: To compare the photomodulation technique using near-infrared LED to conventional respiratory physiotherapy treatment in patients with COVID-19 in reversing acute conditions, reducing hospitalization time, and decreasing the need for oxygen therapy. METHODOLOGY: The cohort was comprised of 30 patients undergoing COVID-19 treatment who were divided and allocated into two equal groups randomly: the LED group (LED), treated with infrared LED at 940 nm and conventional therapy, and the control group (CON), who received conventional treatment (antibiotic therapy for preventing superimposed bacterial infections, and physiotherapy) with LED irradiation off. Phototherapy used a vest with an array of 300 LEDs (940 nm) mounted on a 36 cm × 58 cm area and positioned in the patient's anterior thoracic and abdominal regions. The total power was 6 W, with 15 min irradiation time. Cardiopulmonary functions and blood count were monitored before and after treatment. The patients were treated daily for 7 days. Statistical analysis was conducted using a two-tailed unpaired Student's t-test at a significance level of α = 0.05. RESULTS: Post-treatment, the LED group showed a reduction in hospital discharge time and a statistically significant improvement for the following cardiopulmonary functions: Partial Oxygen Saturation, Tidal Volume, Maximum Inspiratory, and Expiratory Pressures, Respiratory Frequency, Heart Rate, and Systolic Blood Pressure (p < 0.05). Regarding blood count, it was observed that post-treatment, the LED group presented with significant differences in the count of leukocytes, neutrophils, and lymphocytes. CONCLUSION: Photobiomodulation therapy can be used as a complement to conventional treatment of COVID-19, promoting the improvement of cardiopulmonary functions, and minimization of respiratory symptoms.

Systemic Effects of Photobiomodulation on Blood Components in the Treatment of Community-Acquired Pneumonia.

Background: The analysis of the complete blood count (CBC) of patients with community-acquired pneumonia (CAP) is an essential practice both for diagnosing the disease and for evaluating the patient's clinical evolution. It is proposed in the present study to analyze the hematological alterations resulting from photobiostimulation using near-infrared light-emitting diodes (LEDs) in patients with CAP. Methods: This was a clinical, prospective, blinded, and descriptive longitudinal study that involved 21 patients undergoing CAP treatment who were divided into two groups: LED, 11 patients who were treated with infrared LED and conventional treatment; and CON (control), 10 patients who received only conventional treatment (antibiotic therapy and physiotherapy). Physiotherapy was applied before LED irradiation in the LED group. The patients' CBCs were obtained before and after treatment, and erythrocyte counts, hemoglobin and hematocrit concentrations, and leukocyte and platelet counts were assessed. The phototherapy was performed with a vest with an array of 300 LEDs (940 nm) mounted on an area of 36 × 58 cm and positioned in the patient's anterior thoracic and abdominal regions. The total power was 6 W, with 15 min of irradiation time. The patients were treated daily for seven consecutive days. Statistical analyses of the intra- and intergroups of CBC data were done using Student's t-test and one-way ANOVA (analysis of variance), respectively, both at the significance level of α = 0.05. Results: There was a statistically significant recovery difference after treatment in the LED group compared with the CON group for erythrocytes, hemoglobin, leukocytes, segmented and band neutrophils, lymphocytes, and monocytes (p < 0.05). The greatest differences between the LED and CON groups were lymphocyte count reduction (60% vs. 16%), erythrocyte increase (86% vs. 35%), and leukocyte reduction (28% vs. 15%). Conclusions: The hematologic components of CAP patients recovered their normal values faster with conventional treatment associated with infrared LED therapy, thus indicating greater treatment efficiency when compared with the conventional therapy. This study was registered with the Brazilian Registry of Clinical Trials (ReBeC) under Universal Trial Number (UTN) U1111-1229-1296 (2019/06/05).

Photobiomodulation: Shining Light on COVID-19.

Objective: To evaluate the hypothesis that light could reduce the lethality of COVID-19. Methods: Most models for projections of the spread and lethality of COVID-19 take into account the ambient temperature, neglecting light. Recent advances in understanding the mechanism of action of COVID-19 have shown that it causes a systemic infection that significantly affects the hematopoietic system and hemostasis, factors extremely dependent of light, mainly in the region of visible and infrared radiation. Results: In the COVID-19 patients hemoglobin is decreasing and protoporphyrin is increasing, generating an extremely harmful accumulation of iron ions in the bloodstream, which are able to induce an intense inflammatory process in the body with a consequent increase in C-reactive protein and albumin. Observing the unsaturation characteristics of the cyclic porphyrin ring allows it to absorb and emit radiation mainly in the visible region. This characteristic can represent an important differential to change this process in the event of an imbalance in this system, through the photobiomodulation to increase the production of adenosine triphosphate (ATP) using red and near-infrared radiation (R-NIR) and vitamin D using ultraviolet B (UVB) radiation. These two compounds have the primary role of activating the defense mechanisms of the immune system, enabling greater resistance of the individual against the attack by the virus. According to the theory of electron excitation in photosensitive molecules, similar to hemoglobin heme, after the photon absorption there would be an increase in the stability of the iron ion bond with the center of the pyrrole ring, preventing the losses of heme function oxygen transport (HbO2). The light is also absorbed by cytochrome c oxidase in the R-NIR region, with a consequent increase in electron transport, regulating enzyme activity and resulting in a significant increase of oxygen rate consumption by mitochondria, increasing ATP production. Conclusions: The most favorable range of optical radiation to operate in this system is between R-NIR region, in which cytochrome c oxidase and porphyrin present absorption peaks centered at 640 nm and HbO2 with absorption peak centered at 900 nm. Based on the mechanisms described earlier, our hypothesis is that light could reduce the lethality of COVID-19.