Efficacy and safety of ultra-short wave diathermy on COVID-19 pneumonia: a pioneering study
Liangjiang Huang, Qian Li, Sayed Zulfiqar Ali Shah, Mohammad Nasb, Iftikhar Ali, Bin Chen, Lingfeng Xie, Hong Chen
Frontiers in Medicine, doi:10.3389/fmed.2023.1149250
Background: The ultra-short wave diathermy (USWD) is widely used to ameliorate inflammation of bacterial pneumonia, however, for COVID-19 pneumonia, USWD still needs to be verified. This study aimed to investigate the efficacy and safety of USWD in COVID-19 pneumonia patients. Methods: This was a single-center, evaluator-blinded, randomized controlled trial. Moderate and severe COVID-19 patients were recruited between 18 February and 20 April 2020. Participants were randomly allocated to receive USWD + standard medical treatment (USWD group) or standard medical treatment alone (control group). The negative conversion rate of SARS-CoV-2 and Systemic Inflammatory Response Scale (SIRS) on days 7, 14, 21, and 28 were assessed as primary outcomes. Secondary outcomes included time to clinical recovery, the 7-point ordinal scale, and adverse events. Results: Fifty patients were randomized (USWD, 25; control, 25), which included 22 males (44.0%) and 28 females (56.0%) with a mean (SD) age of 53 ± 10.69. The rates of SARS-CoV-2 negative conversion on day 7 (p = 0.066), day 14 (p = 0.239), day 21 (p = 0.269), and day 28 (p = 0.490) were insignificant. However, systemic inflammation by SIRS was ameliorated with significance on day 7 (p = 0.030), day 14 (p = 0.002), day 21 (p = 0.003), and day 28 (p = 0.011). Time to clinical recovery (USWD 36.84 ± 9.93 vs. control 43.56 ± 12.15, p = 0.037) was significantly shortened with a between-group difference of 6.72 ± 3.14 days. 7-point ordinal scale on days 21 and 28 showed significance (p = 0.002, 0.003), whereas the difference on days 7 and 14 was insignificant (p = 0.524, 0.108). In addition, artificial intelligenceassisted CT analysis showed a greater decrease in the infection volume in the USWD group, without significant between-group differences. No treatmentassociated adverse events or worsening of pulmonary fibrosis were observed in either group. Conclusion: Among patients with moderate and severe COVID-19 pneumonia, USWD added to standard medical treatment could ameliorate systemic inflammation and shorten the duration of hospitalization without causing any adverse effects.
Ethics statement The studies involving human participants were reviewed and approved by The ethics committee of the Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (certificate of approval number: TJ-C20200127). The patients/participants provided their written informed consent to participate in this study.
Author contributions HC contributed to the supervision, drafting, and finalizing of the study. LH, QL, and SS equally contributed to compiling and describing the results. Moreover, authors LH and QL contributed to designing the CRF, medical history forms development, data collection, and interpretation. SS and MN contributed to writing and formatting the manuscript. LX designed the USWD treatment protocol, while BC did the CT scan analysis. IA contributed to data analysis. All authors contributed to the article and approved the submitted version.
Conflict of interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Publisher's note All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.
Supplementary..
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'abstract': '<jats:sec><jats:title>Background</jats:title><jats:p>The ultra-short wave diathermy (USWD) is '
'widely used to ameliorate inflammation of bacterial pneumonia, however, for COVID-19 '
'pneumonia, USWD still needs to be verified. This study aimed to investigate the efficacy and '
'safety of USWD in COVID-19 pneumonia '
'patients.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>This was a '
'single-center, evaluator-blinded, randomized controlled trial. Moderate and severe COVID-19 '
'patients were recruited between 18 February and 20 April 2020. Participants were randomly '
'allocated to receive USWD + standard medical treatment (USWD group) or standard medical '
'treatment alone (control group). The negative conversion rate of SARS-CoV-2 and Systemic '
'Inflammatory Response Scale (SIRS) on days 7, 14, 21, and 28 were assessed as primary '
'outcomes. Secondary outcomes included time to clinical recovery, the 7-point ordinal scale, '
'and adverse '
'events.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Fifty patients '
'were randomized (USWD, 25; control, 25), which included 22 males (44.0%) and 28 females '
'(56.0%) with a mean (SD) age of 53 ± 10.69. The rates of SARS-CoV-2 negative conversion on '
'day 7 (<jats:italic>p</jats:italic>\u2009=\u20090.066), day 14 '
'(<jats:italic>p</jats:italic>\u2009=\u20090.239), day 21 (<jats:italic>p</jats:italic>\u2009'
'=\u20090.269), and day 28 (<jats:italic>p</jats:italic>\u2009=\u20090.490) were '
'insignificant. However, systemic inflammation by SIRS was ameliorated with significance on '
'day 7 (<jats:italic>p</jats:italic>\u2009=\u20090.030), day 14 '
'(<jats:italic>p</jats:italic>\u2009=\u20090.002), day 21 (<jats:italic>p</jats:italic>\u2009'
'=\u20090.003), and day 28 (<jats:italic>p</jats:italic>\u2009=\u20090.011). Time to clinical '
'recovery (USWD 36.84\u2009±\u20099.93 vs. control 43.56\u2009±\u200912.15, '
'<jats:italic>p</jats:italic>\u2009=\u20090.037) was significantly shortened with a '
'between-group difference of 6.72\u2009±\u20093.14\u2009days. 7-point ordinal scale on days 21 '
'and 28 showed significance (<jats:italic>p</jats:italic>\u2009=\u20090.002, 0.003), whereas '
'the difference on days 7 and 14 was insignificant (<jats:italic>p</jats:italic>\u2009=\u2009'
'0.524, 0.108). In addition, artificial intelligence-assisted CT analysis showed a greater '
'decrease in the infection volume in the USWD group, without significant between-group '
'differences. No treatment-associated adverse events or worsening of pulmonary fibrosis were '
'observed in either '
'group.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Among patients '
'with moderate and severe COVID-19 pneumonia, USWD added to standard medical treatment could '
'ameliorate systemic inflammation and shorten the duration of hospitalization without causing '
'any adverse effects.</jats:p><jats:p><jats:bold>Clinical Trial Registration</jats:bold>: '
'<jats:ext-link>chictr.org.cn</jats:ext-link>, identifier '
'ChiCTR2000029972.</jats:p></jats:sec>',
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