La radioteràpia a dosis baixes: una alternativa terapèutica en pacients ancians amb pneumònia severa causada per COVID-19

Identificador:  TDX:4105

Handle: https://hdl.handle.net/20.500.11797/TDX4105

Autors:  Piqué Smith, Berta

Resum:
In December 2019, the new severe acute respiratory syndrome type 2 (SARS-CoV-2) coronavirus, which causes COVID-19, was identified in China and would cause one of the largest pandemics in human history. During SARS-CoV-2 infection, immune system dysregulation occurs, resulting in a hyperinflammatory state called cytokine storm (CS), which can lead to pneumonia. Low-dose radiotherapy (LD-RT), due to its recognised anti-inflammatory and immunomodulatory effects, was considered a potentially effective treatment for COVID-19. This PhD thesis reports the largest clinical trial to date studying the effects of LD-RT on COVID-19 pneumonia. Our results show that LD-RT improves the respiratory function of treated patients, increases survival, and reduces the length of hospitalisation along with the duration of symptoms. We have also studied blood markers that could be associated with a higher mortality rate and possible response to RT. We have proven that serum viral load of patients collected 24 hours before LD-RT is associated with increased mortality 30 days post-treatment. Also, that a positive correlation exists with higher CURB-65 scores and higher blood lactate dehydrogenase (LDH) concentrations, and finally, that serum viral load variable combined with pre-treatment blood parameters, such as aspartate aminotransferase (AST) and LDH, are predictive of 30-day post-treatment mortality. In summary, this PhD thesis supports and represents a very relevant advance in the knowledge of the benefits and possible radiobiological effects of LD-RT in COVID-19 pneumonia.