The Clinical Effects of Laser Acupuncture on Hospitalized Patients With Severe COVID-19: A Randomized Clinical Trial The clinical effects of laser acupuncture on COVID-19 severity
Journal of Lasers in Medical Sciences,
Vol. 14 (2023),
29 January 2023
,
Page e14
Abstract
Introduction: The coronavirus disease (COVID-19) was extended to the entire population in China and around the world, and its mortality rate was about 3.4%. The impact of laser therapy on chronic respiratory diseases has been shown in previous studies. This study was aimed at examining the effects of laser acupuncture (LA) on patients with severe COVID-19.
Methods: In the present study, 60 patients with a positive reverse transcription-polymerase chain reaction (RT-PCR) test were assigned to the intervention and control groups (30 patients in each group). The intervention group was treated with LA, that is, laser light with low energy on acupuncture points, once a day for five consecutive days.
Results: The participants’ mean age in the intervention and control groups was 48.96±12.65 and 53.16±12.28 respectively; 70% of the patients were male and 30% of them were female. IL6 had a significant reduction in the intervention group (P value=0.038) in comparison with the control group (P value=0.535). Furthermore, the mean admission time in the control group was significantly higher than that in the intervention group (P value=0.047). However, the mortality rate in the intervention group was zero, but three patients in the control group died.
Conclusion: Our study showed that LA can be used as supportive therapy for routine treatment in patients with severe COVID-19. Moreover, due to LA safety and its low cost, it could be recommended as an adjuvant to conventional therapy in patients interested in treating their disease with such a method.
Keywords:
- Laser acupuncture; Laser therapy; COVID-19; Severity
How to Cite
Shojaeddin, A. ., Fatemi, A. ., Razzaghi, Z., Pishgahi, M. ., Jahani Sherafat, S. ., Razzaghi, M. R., Shahrzad, M. K. ., Anaraki, N. ., Salehi, C. ., & Amiri, A. . (2023). The Clinical Effects of Laser Acupuncture on Hospitalized Patients With Severe COVID-19: A Randomized Clinical Trial: The clinical effects of laser acupuncture on COVID-19 severity. Journal of Lasers in Medical Sciences, 14, e14. Retrieved from https://journals.sbmu.ac.ir/jlms/article/view/39829
References
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17. Chon TY, Lee MC. Acupuncture. Mayo Clinic Proceedings. 2013;88(10):1141-6.
18. Chow R. Laser acupuncture studies should not be included in systematic reviews of phototherapy. Photomedicine and laser surgery. 2006;24(1):69-.
19. Glazov G, Yelland M, Emery J. Low-dose laser acupuncture for non-specific chronic low back pain: a double-blind randomised controlled trial. Acupuncture in Medicine. 2014;32(2):116-23.
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21. Chow R, Yan W, Armati P. Electrophysiological effects of single point transcutaneous 650 and 808 nm laser irradiation of rat sciatic nerve: a study of relevance for low-level laser therapy and laser acupuncture. Photomedicine and laser surgery. 2012;30(9):530-5.
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26. Fengxia L, Gerhard L. COVID-19 (Coronavirus Disease-19): Traditional chinese medicine including acupuncture for alleviation–A report from Wuhan, Hubei Province in China. LIDSEN Publishing Inc; 2020.
27. Sigman SA, Mokmeli S, Monici M, Vetrici MA. A 57-year-old african american man with severe COVID-19 pneumonia who responded to supportive photobiomodulation therapy (PBMT): first use of PBMT in COVID-19. The American Journal of Case Reports. 2020;21:e926779-1.
28. Sigman SA, Mokmeli S, Vetrici MA. Adjunct low level laser therapy (LLLT) in a morbidly obese patient with severe COVID-19 pneumonia: A case report. Canadian journal of respiratory therapy: CJRT= Revue canadienne de la therapie respiratoire: RCTR. 2020;56:52.
29. Wen D, Wu L, Dong Y, Huang J, Ren K, Jiang J, et al. The effect of acupuncture on the quality of life of patients recovering from COVID-19: A systematic review protocol. Medicine. 2020;99(30).
30. Wool GD, Miller JL. The impact of COVID-19 disease on platelets and coagulation. Pathobiology. 2021;88(1):14-26.
31. Llitjos JF, Leclerc M, Chochois C, Monsallier JM, Ramakers M, Auvray M, et al. High incidence of venous thromboembolic events in anticoagulated severe COVID‐19 patients. Journal of Thrombosis and Haemostasis. 2020;18(7):1743-6.
32. The Lancet H. COVID-19 coagulopathy: an evolving story. Lancet Haematol. 2020;7(6):e425-e.
33. Drohomirecka A, Iwaszko A, Walski T, Pliszczak-Król A, Wąż G, Graczyk S, et al. Low-level light therapy reduces platelet destruction during extracorporeal circulation. Scientific reports. 2018;8(1):1-9.
34. Güçlü E, Kocayiğit H, Okan HD, Erkorkmaz U, Yürümez Y, Yaylacı S, et al. Effect of COVID-19 on platelet count and its indices. Revista da Associação Médica Brasileira. 2020;66:1122-7.
35. Guo A, Lu J, Tan H, Kuang Z, Lou Y, Yang T, et al. Risk Factors on Admission Associated with Hospital Length of Stay in Patients with COVID-19: A Retrospective Cohort Study. Available at SSRN 3582769. 2020.
36. Rees EM, Nightingale ES, Jafari Y, Waterlow NR, Clifford S, Pearson CA, et al. COVID-19 length of hospital stay: a systematic review and data synthesis. BMC medicine. 2020;18(1):1-22.
37. Nejatifard M, Asefi S, Jamali R, Hamblin MR, Fekrazad R. Probable positive effects of the photobiomodulation as an adjunctive treatment in COVID-19: A systematic review. Cytokine. 2021;137:155312.
38. Mohamed AR, Shaban MM. Role of laser acupuncture in chronic respiratory diseases. Egyptian Journal of Chest Diseases and Tuberculosis. 2014;63(4):1065-70.
39. Scheewe S, Vogt L, Minakawa S, Eichmann D, Welle S, Stachow R, et al. Acupuncture in children and adolescents with bronchial asthma: a randomised controlled study. Complementary therapies in medicine. 2011;19(5):239-46.
40. Fung KP, Chow OKW, So SY. Attenuation of exercise-induced asthma by acupuncture. The Lancet. 1986;328(8521-8522):1419-22.
41. Chow OK, So S, Lam W, Yu D, Yeung C. Effect of acupuncture on exercise-induced asthma. Lung. 1983;161(1):321-6.
42. Rostamian A, Ghazanfari T, Arabkheradmand J, Edalatifard M, Ghaffarpour S, Salehi MR, et al. Interleukin-6 as a Potential Predictor of COVID-19 disease severity in hospitalized patients and its association with clinical laboratory routine tests. Immunoregulation. 2020;3(1):29-36.
43. Aimbire F, Albertini R, Pacheco M, Castro-Faria-Neto H, Leonardo P, Iversen V, et al. Low-level laser therapy induces dose-dependent reduction of TNFα levels in acute inflammation. Photomedicine and laser surgery. 2006;24(1):33-7.
44. de Lima FM, Villaverde A, Salgado M, Castro-Faria-Neto H, Munin E, Albertini R, et al. Low intensity laser therapy (LILT) in vivo acts on the neutrophils recruitment and chemokines/cytokines levels in a model of acute pulmonary inflammation induced by aerosol of lipopolysaccharide from Escherichia coli in rat. Journal of Photochemistry and Photobiology B: Biology. 2010;101(3):271-8.
45. de Lima FM, Villaverde A, Albertini R, Corrêa J, Carvalho R, Munin E, et al. Dual Effect of low‐level laser therapy (LLLT) on the acute lung inflammation induced by intestinal ischemia and reperfusion: Action on anti‐and pro‐inflammatory cytokines. Lasers in Surgery and Medicine. 2011;43(5):410-20.
46. de Lima FM, Moreira LM, Villaverde A, Albertini R, Castro-Faria-Neto HC, Aimbire F. Low-level laser therapy (LLLT) acts as cAMP-elevating agent in acute respiratory distress syndrome. Lasers in medical science. 2011;26(3):389-400.
47. Meduri GU, Headley S, Kohler G, Stentz F, Tolley E, Umberger R, et al. Persistent elevation of inflammatory cytokines predicts a poor outcome in ARDS: plasma IL-1β and IL-6 levels are consistent and efficient predictors of outcome over time. Chest. 1995;107(4):1062-73.
48. Fu P-K, Wu C-L, Tsai T-H, Hsieh C-L. Anti-inflammatory and anticoagulative effects of paeonol on LPS-induced acute lung injury in rats. Evidence-Based Complementary and Alternative Medicine. 2012;2012.
49. Aimbire F, De Oliveira AL, Albertini R, Correa J, De Campos CL, Lyon J, et al. Low level laser therapy (LLLT) decreases pulmonary microvascular leakage, neutrophil influx and IL-1β levels in airway and lung from rat subjected to LPS-induced inflammation. Inflammation. 2008;31(3):189.
2. Tian W, Jiang W, Yao J, Nicholson CJ, Li RH, Sigurslid HH, et al. Predictors of mortality in hospitalized COVID‐19 patients: A systematic review and meta‐analysis. Journal of medical virology. 2020;92(10):1875-83.
3. Chen R, Liang W, Jiang M, Guan W, Zhan C, Wang T, et al. Risk factors of fatal outcome in hospitalized subjects with coronavirus disease 2019 from a nationwide analysis in China. Chest. 2020;158(1):97-105.
4. The Novel Coronavirus Pneumonia Emergency Response Epidemiology T. The Epidemiological Characteristics of an Outbreak of 2019 Novel Coronavirus Diseases (COVID-19) - China, 2020. China CDC Wkly. 2020;2(8):113-22.
5. Moskvin SV, Agasarov LG. Laser Acupuncture: 35 Years of Successful Application in Russia (Narrative Review). J Lasers Med Sci. 2020;11(4):381-9.
6. Bjordal JM, Lopes-Martins RAB, Joensen J, Iversen VV. The anti-inflammatory mechanism of low level laser therapy and its relevance for clinical use in physiotherapy. Physical Therapy Reviews. 2010;15(4):286-93.
7. Jang H, Lee H. Meta-analysis of pain relief effects by laser irradiation on joint areas. Photomedicine and laser surgery. 2012;30(8):405-17.
8. Mokmeli S, Vetrici M. Low level laser therapy as a modality to attenuate cytokine storm at multiple levels, enhance recovery, and reduce the use of ventilators in COVID-19. Canadian journal of respiratory therapy: CJRT= Revue canadienne de la therapie respiratoire: RCTR. 2020;56:25.
9. Mokmeli S, Vetrici M. Low level laser therapy as a modality to attenuate cytokine storm at multiple levels, enhance recovery, and reduce the use of ventilators in COVID-19. Can J Respir Ther. 2020;56:25-31.
10. Smoot B, Chiavola-Larson L, Lee J, Manibusan H, Allen DD. Effect of low-level laser therapy on pain and swelling in women with breast cancer-related lymphedema: a systematic review and meta-analysis. Journal of Cancer Survivorship. 2015;9(2):287-304.
11. Rayegani SM, Bayaat M, Sedighipour L, Samadi B. LOW INTENSITY LASER THERAPY BASICS AND CLINICAL APPLICATIONS. J Lasers Med Sci. 2010;1(1):31-4.
12. Sayed MA, El-Sherif RM, Mohamed AR, El-Sherif AA. Low-level laser therapy in chronic obstructive lung disease. Egyptian Journal of Bronchology. 2018;12(3):317-22.
13. da Cunha Moraes G, Vitoretti LB, de Brito AA, Alves CE, de Oliveira NCR, dos Santos Dias A, et al. Low-Level Laser Therapy Reduces Lung Inflammation in an Experimental Model of Chronic Obstructive Pulmonary Disease Involving P2X7 Receptor. Oxidative Medicine and Cellular Longevity. 2018;2018:6798238.
14. Brito A, Santos TG, Alves CE, Rigonato-Oliveira NC, Vitoretti LB, Rodrigues Brandão-Rangel MA, et al. Anti-inflammatory effects of Low Level Laser (LLL) in a murine model of asthma and its combination with the standard treatment. European Respiratory Journal. 2017;50(suppl 61):PA1048.
15. NIo H. Guidelines on Acupuncture and Moxibustion Intervention for COVID-19 (second edition) 2021 [Available from: https://www.wfas.org.cn/.
16. Chon TY, Mallory MJ, Yang J, Bublitz SE, Do A, Dorsher PT. Laser acupuncture: a concise review. Medical acupuncture. 2019;31(3):164-8.
17. Chon TY, Lee MC. Acupuncture. Mayo Clinic Proceedings. 2013;88(10):1141-6.
18. Chow R. Laser acupuncture studies should not be included in systematic reviews of phototherapy. Photomedicine and laser surgery. 2006;24(1):69-.
19. Glazov G, Yelland M, Emery J. Low-dose laser acupuncture for non-specific chronic low back pain: a double-blind randomised controlled trial. Acupuncture in Medicine. 2014;32(2):116-23.
20. Litscher G, Wang L, Wang X, Gaischek I. Laser acupuncture: two acupoints (Baihui, Neiguan) and two modalities of laser (658 nm, 405 nm) induce different effects in neurovegetative parameters. Evidence-Based Complementary and Alternative Medicine. 2013;2013.
21. Chow R, Yan W, Armati P. Electrophysiological effects of single point transcutaneous 650 and 808 nm laser irradiation of rat sciatic nerve: a study of relevance for low-level laser therapy and laser acupuncture. Photomedicine and laser surgery. 2012;30(9):530-5.
22. Health NIo. Clinical Spectrum of SARS-CoV-2 Infection 2021 [updated Last Updated: April 21, 2021. Available from: https://www.covid19treatmentguidelines.nih.gov/overview/clinical-spectrum/.
23. (WFAS) WFOAAMS. Guidelines on Acupuncture and Moxibustion Intervention for COVID-19 (second edition) 2021 [Available from: https://www.wfas.org.cn/.
24. Fekrazad R. Photobiomodulation and antiviral photodynamic therapy as a possible novel approach in COVID-19 management. Mary Ann Liebert, Inc., publishers 140 Huguenot Street, 3rd Floor New …; 2020.
25. Jahani-Sherafat S, Mokmeli S, Rostami-Nejad M, Razzaghi Z, Tavirani MR, Razzaghi M. The Effectiveness of Photobiomudulation Therapy (PBMT) in COVID-19 Infection. Journal of Lasers in Medical Sciences. 2020;11.
26. Fengxia L, Gerhard L. COVID-19 (Coronavirus Disease-19): Traditional chinese medicine including acupuncture for alleviation–A report from Wuhan, Hubei Province in China. LIDSEN Publishing Inc; 2020.
27. Sigman SA, Mokmeli S, Monici M, Vetrici MA. A 57-year-old african american man with severe COVID-19 pneumonia who responded to supportive photobiomodulation therapy (PBMT): first use of PBMT in COVID-19. The American Journal of Case Reports. 2020;21:e926779-1.
28. Sigman SA, Mokmeli S, Vetrici MA. Adjunct low level laser therapy (LLLT) in a morbidly obese patient with severe COVID-19 pneumonia: A case report. Canadian journal of respiratory therapy: CJRT= Revue canadienne de la therapie respiratoire: RCTR. 2020;56:52.
29. Wen D, Wu L, Dong Y, Huang J, Ren K, Jiang J, et al. The effect of acupuncture on the quality of life of patients recovering from COVID-19: A systematic review protocol. Medicine. 2020;99(30).
30. Wool GD, Miller JL. The impact of COVID-19 disease on platelets and coagulation. Pathobiology. 2021;88(1):14-26.
31. Llitjos JF, Leclerc M, Chochois C, Monsallier JM, Ramakers M, Auvray M, et al. High incidence of venous thromboembolic events in anticoagulated severe COVID‐19 patients. Journal of Thrombosis and Haemostasis. 2020;18(7):1743-6.
32. The Lancet H. COVID-19 coagulopathy: an evolving story. Lancet Haematol. 2020;7(6):e425-e.
33. Drohomirecka A, Iwaszko A, Walski T, Pliszczak-Król A, Wąż G, Graczyk S, et al. Low-level light therapy reduces platelet destruction during extracorporeal circulation. Scientific reports. 2018;8(1):1-9.
34. Güçlü E, Kocayiğit H, Okan HD, Erkorkmaz U, Yürümez Y, Yaylacı S, et al. Effect of COVID-19 on platelet count and its indices. Revista da Associação Médica Brasileira. 2020;66:1122-7.
35. Guo A, Lu J, Tan H, Kuang Z, Lou Y, Yang T, et al. Risk Factors on Admission Associated with Hospital Length of Stay in Patients with COVID-19: A Retrospective Cohort Study. Available at SSRN 3582769. 2020.
36. Rees EM, Nightingale ES, Jafari Y, Waterlow NR, Clifford S, Pearson CA, et al. COVID-19 length of hospital stay: a systematic review and data synthesis. BMC medicine. 2020;18(1):1-22.
37. Nejatifard M, Asefi S, Jamali R, Hamblin MR, Fekrazad R. Probable positive effects of the photobiomodulation as an adjunctive treatment in COVID-19: A systematic review. Cytokine. 2021;137:155312.
38. Mohamed AR, Shaban MM. Role of laser acupuncture in chronic respiratory diseases. Egyptian Journal of Chest Diseases and Tuberculosis. 2014;63(4):1065-70.
39. Scheewe S, Vogt L, Minakawa S, Eichmann D, Welle S, Stachow R, et al. Acupuncture in children and adolescents with bronchial asthma: a randomised controlled study. Complementary therapies in medicine. 2011;19(5):239-46.
40. Fung KP, Chow OKW, So SY. Attenuation of exercise-induced asthma by acupuncture. The Lancet. 1986;328(8521-8522):1419-22.
41. Chow OK, So S, Lam W, Yu D, Yeung C. Effect of acupuncture on exercise-induced asthma. Lung. 1983;161(1):321-6.
42. Rostamian A, Ghazanfari T, Arabkheradmand J, Edalatifard M, Ghaffarpour S, Salehi MR, et al. Interleukin-6 as a Potential Predictor of COVID-19 disease severity in hospitalized patients and its association with clinical laboratory routine tests. Immunoregulation. 2020;3(1):29-36.
43. Aimbire F, Albertini R, Pacheco M, Castro-Faria-Neto H, Leonardo P, Iversen V, et al. Low-level laser therapy induces dose-dependent reduction of TNFα levels in acute inflammation. Photomedicine and laser surgery. 2006;24(1):33-7.
44. de Lima FM, Villaverde A, Salgado M, Castro-Faria-Neto H, Munin E, Albertini R, et al. Low intensity laser therapy (LILT) in vivo acts on the neutrophils recruitment and chemokines/cytokines levels in a model of acute pulmonary inflammation induced by aerosol of lipopolysaccharide from Escherichia coli in rat. Journal of Photochemistry and Photobiology B: Biology. 2010;101(3):271-8.
45. de Lima FM, Villaverde A, Albertini R, Corrêa J, Carvalho R, Munin E, et al. Dual Effect of low‐level laser therapy (LLLT) on the acute lung inflammation induced by intestinal ischemia and reperfusion: Action on anti‐and pro‐inflammatory cytokines. Lasers in Surgery and Medicine. 2011;43(5):410-20.
46. de Lima FM, Moreira LM, Villaverde A, Albertini R, Castro-Faria-Neto HC, Aimbire F. Low-level laser therapy (LLLT) acts as cAMP-elevating agent in acute respiratory distress syndrome. Lasers in medical science. 2011;26(3):389-400.
47. Meduri GU, Headley S, Kohler G, Stentz F, Tolley E, Umberger R, et al. Persistent elevation of inflammatory cytokines predicts a poor outcome in ARDS: plasma IL-1β and IL-6 levels are consistent and efficient predictors of outcome over time. Chest. 1995;107(4):1062-73.
48. Fu P-K, Wu C-L, Tsai T-H, Hsieh C-L. Anti-inflammatory and anticoagulative effects of paeonol on LPS-induced acute lung injury in rats. Evidence-Based Complementary and Alternative Medicine. 2012;2012.
49. Aimbire F, De Oliveira AL, Albertini R, Correa J, De Campos CL, Lyon J, et al. Low level laser therapy (LLLT) decreases pulmonary microvascular leakage, neutrophil influx and IL-1β levels in airway and lung from rat subjected to LPS-induced inflammation. Inflammation. 2008;31(3):189.
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