Proposal of a clinical trial using anti-inflammatory radiation to lessen cytokine release and lower mortality from COVID-19

1. Low Dose Radiation for Mild to
Moderately Symptomatic
COVID-19
Conceptual for trial, do not try
Matt Katz, MD

2. Hypothesis
• Low dose radiation can interfere with
inflammatory cascade to reduce severity of
cytokine release
• Treatment with low dose radiation can lessen
mortality for symptomatic patients with
COVID-19

3. Who is the ideal cohort?
• ? Confirmed COVID+ patients before cytokine
release occurs
• Delays in diagnosis may preclude molecular
test so can consider thoracic imaging

4. Use of chest CT
• CT imaging may detect before positive
molecular testing and may identify higher risk
patients
– Li et al, Korean J Radiol
• CT findings correlate with mortality in COVID-
19
– Yuan M et al PLoS ONE

5. Design?
Confirmed
COVID19 by history and CT
Randomize to
0 cGy 30 cGy
x 5
60 cGy
x 5
60 cGy
x 10
Radiation target volume = whole thorax including heart

6. Early Endpoints (4 weeks)
• Requiring ventilation
• Mortality

7. Stratify by ?
• Age
• Diabetes
• Cardiac disease
• Neutrophil count