Combination therapy using low dose radiation,plasma exchange,and a robust antiviral may induce synergic beneficial interactions for mitigating severe COVID‐19

摘要

Recent studies confirm that current antiviral drugs are not fully effective on coronaviruses.Our research team introduced the idea of radiotherapy at low doses for coronavirus disease 2019(COVID-19)in March 2020.This issue later received much attention from many scientists around the world.Low dose radiation therapy exerts modulatory effects in acute inflammation,potentiate the anti-viral immune responses,and can be localized to the organ affected by inflammatory reactions,such as lungs.The findings of the first clinical trial show that low dose radiation therapy is safe,and reveal early promise of efficacy.Moreover,plasma exchange therapy may be a rescue therapy in severe COVID-19 patients,as it can quickly eliminate the cytokines and chemokines from the circulation.Remdesivir was introduced as an anti-virus agent that prevents viral RNA synthesis and coronavirus replication and reduces the viral load.If antiviral therapy is poor,the virus has ample opportunity to mutate and increase its fitness through adaptive mutations.Given this consideration,instead a single treatment,we preferentially recommend a combination therapy using low dose radiation therapy plasma exchange and a robust antiviral agent(not yet available).This review provides a viewpoint concerning the potential synergistic effects of low dose radiation therapy,plasma exchange therapy and robust antiviral agent in severe acute respiratory syndrome coronavirus type 2(SARS-CoV-2)-infected patients as a more effective strategy for possible treatment of severe COVID-19 patients.