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CC BY-NC-ND 4.0 · Ultraschall Med 2023; 44(06): e274-e283
DOI: 10.1055/a-2133-0835
Original Article

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

Wirksamkeit von niedrigenergetischem gepulstem Ultraschall bei der Behandlung von COVID-19-Pneumonien
Wen Li‡
1   Department of Ultrasound, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China (Ringgold ID: RIN12474)
,
Xiao Li‡
2   Department of Ultrasound, Institute of Ultrasound in Medicine and Engineering, Zhongshan Hospital, Fudan University, Shanghai, China (Ringgold ID: RIN12474)
,
Zhibin Kong‡
3   Respiratory Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China (Ringgold ID: RIN12474)
,
Bin Chen‡
4   Cardiovascular Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China (Ringgold ID: RIN12474)
,
Hongsheng Zhou
5   Shanghai Acoustics Jiao Tong University, Shanghai, China
,
Yimin Jiang
1   Department of Ultrasound, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China (Ringgold ID: RIN12474)
,
Weimei Li
1   Department of Ultrasound, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China (Ringgold ID: RIN12474)
,
Lichang Zhong
1   Department of Ultrasound, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China (Ringgold ID: RIN12474)
,
Xinyu Zhang
1   Department of Ultrasound, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China (Ringgold ID: RIN12474)
,
Kaihua Zhang
6   Department of Radiology, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China (Ringgold ID: RIN12474)
,
Lili Zhang
4   Cardiovascular Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China (Ringgold ID: RIN12474)
,
Xiangyun Zong
7   Breast Surgery, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China (Ringgold ID: RIN12474)
,
Wenkun Bai 
8   Department of Ultrasound, Tong Ji Hospital Affiliated to Tong Ji University, Shanghai, China
,
Yuanyi Zheng
1   Department of Ultrasound, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China (Ringgold ID: RIN12474)
› Author AffiliationsSupported by: Shanghai Science and Technology Commission 21Y11910900
Supported by: National Key R&D Program 2021YFC2009100
Supported by: Shanghai Sixth People's Hospital COVID-19 Pneumonia Epidemic Emergency Special Project ynxg202209
Supported by: Shanghai Sixth People's Hospital Surface Cultivation Project ynms202110

TRIAL REGISTRATION: Registration number (trial ID): ChiCTR2200059550, Trial registry: Chinese Clinical Trial Registry (http://www.chictr.org/), Type of Study: Randomized
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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

Supporting information



Publication History

Received: 28 September 2022

Accepted after revision: 13 July 2023

Accepted Manuscript online:
19 July 2023

Article published online:
04 December 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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