Low-field thoracic magnetic stimulation increases peripheral oxygen saturation levels in coronavirus disease (COVID-19) patients: A single-blind, sham-controlled, crossover study

Saul M Dominguez-Nicolas, Elias Manjarrez, Saul M Dominguez-Nicolas, Elias Manjarrez

Abstract

Severe acute respiratory syndrome coronavirus-2 may cause low oxygen saturation (SpO2) and respiratory failure in patients with coronavirus disease (COVID-19). Hence, increased SpO2 levels in COVID-19 patients could be crucial for their quality of life and recovery. This study aimed to demonstrate that a 30-minute single session of dorsal low-field thoracic magnetic stimulation (LF-ThMS) can be employed to increase SpO2 levels in COVID-19 patients significantly. Furthermore, we hypothesized that the variables associated with LF-ThMS, such as frequency, magnetic flux density, and temperature in the dorsal thorax, might be correlated to SpO2 levels in these patients.Here we employed an LF-ThMS device to noninvasively deliver a pulsed magnetic field from 100 to 118 Hz and 10.5 to 13.1 milliTesla (i.e., 105 to 131 Gauss) to the dorsal thorax. These values are within the intensity range of several pulsed electromagnetic field devices employed in physical therapy worldwide. We designed a single-blind, sham-controlled, crossover study on 5 COVID-19 patients who underwent 2 sessions of the study (real and sham LF-ThMS) and 12 patients who underwent only the real LF-ThMS.We found a statistically significant positive correlation between magnetic flux density, frequency, or temperature, associated with the real LF-ThMS and SpO2 levels in all COVID-19 patients. However, the 5 patients in the sham-controlled study did not exhibit a significant change in their SpO2 levels during sham stimulation. The employed frequencies and magnetic flux densities were safe for the patients. We did not observe adverse events after the LF-ThMS intervention.This study is a proof-of-concept that a single session of LF-ThMS applied for 30 minutes to the dorsal thorax of 17 COVID-19 patients significantly increased their SpO2 levels. However, future research will be needed to understand the physiological mechanisms behind this finding.The study was registered at ClinicalTrials.gov (Identifier: NCT04895267, registered on May 20, 2021) retrospectively registered. https://ichgcp.net/clinical-trials-registry/NCT04895267.

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

Figures

Figure 1
Figure 1
Electronic circuits employed in the LF-ThMS device. These circuits modulate the intensity and frequency of the alternating current producing the magnetic fields, limiting the maximum temperature to 44 °C, and the magnetic flux density up to 13.1 mT at 118 Hz. LF-ThMS = low-field thoracic magnetic stimulation.
Figure 2
Figure 2
Experimental arrangement. A. Anatomical landmarks for the positioning of LF-ThMS coils on the dorsal thorax of COVID-19 patients. The gray circle indicates the anatomical landmark called the “spinous process of C7” or “vertebra prominens”. B-D. Gradual increase (every 5 min) from 0 to 30 min of pulsed stimulus frequency, magnetic flux density, and temperature during the application of LF-ThMS to COVID-19 patients. The stimulation consisted of applying LF-ThMS for 30 min on the dorsal aspect of the thorax. COVID-19 = coronavirus disease of 2019, LF-ThMS = low-field thoracic magnetic stimulation.
Figure 3
Figure 3
Comparative results obtained from the sham-controlled study and the real LF-ThMS intervention. A. Peripheral oxygen saturation (SpO2) levels vs time during the sham stimulation for 5 COVID-19 patients. Blue circles represent the grand average of these SpO2 levels B. SpO2 levels vs time during LF-ThMS stimulation. The green triangles represent the grand average of SpO2 values during real LF-ThMS in the same 5 patients that received sham stimulation in A. The orange symbols illustrate the grand average of SpO2 levels in 12 COVID-19 patients vs time during a single session of LF-ThMS. The green and gray circles (raw data) show the SpO2 values obtained for all the patients (every 5 min) vs the time in minutes. A statistically significant correlation (P < .001, Pearson product-moment correlation) was found for “SpO2 values” vs “stimulation time” during real LF-ThMS but not during sham stimulation. All SpO2 measurements in the control and sham conditions were taken at least 35 min after the patients rested in a prone position. Therefore, only SpO2 measurements in the prone position were used for comparison. COVID-19 = coronavirus disease of 2019, LF-ThMS = low-field thoracic magnetic stimulation, SpO2 = oxygen saturation.
Figure 4
Figure 4
The same as Figure 3B, but it refers to the correlation between SpO2 levels and the variables related to the real LF-ThMS applied to 17 patients. The Pearson correlation coefficients (r), degrees of freedom (DF), and P values (P < .001) are shown above each graph. LF-ThMS = low-field thoracic magnetic stimulation, SpO2 = oxygen saturation.

References

    1. Babaei F, Mirzababaei M, Nassiri-Asl M, Hosseinzadeh H. Review of registered clinical trials for the treatment of COVID-19. Drug Dev Res 2020;82:474–93.
    1. Haneef K, Asghar MU, Ali A. Novel immunogenomic insights of corona virus disease (COVID-19): available potential immunotherapeutics, current challenges, immune cell recognition and ongoing managerial strategies. Biomed Res Ther 2020;7:3906–15.
    1. Tobaiqy M, Qashqary M, Al-Dahery S, et al. . Therapeutic management of patients with COVID-19: a systematic review. Infect Prev Pract 2020;2:100061.
    1. Chen P-L, Lee N-Y, Cia C-T, Ko W-C, Hsueh P-R. A review of treatment of Coronavirus disease 2019 (COVID-19): therapeutic repurposing and unmet clinical needs. Front Pharmacol 2020;11:584956.
    1. Daou F, Abou-Sleymane G, Badro DA, Khanafer N, Tobaiqy M, Al Faraj A. The history, efficacy, and safety of potential therapeutics: a narrative overview of the complex life of COVID-19. Int J Environ Res Public Health 2021;18:955.
    1. Gálvez-Romero JL, Palmeros-Rojas O, Real-Ramírez FA, et al. . Cyclosporine A plus low-dose steroid treatment in COVID-19 improves clinical outcomes in patients with moderate to severe disease: a pilot study. J Intern Med 2020;289:906–20.
    1. Naveja JJ, Madariaga-Mazón A, Flores-Murrieta F, et al. . Union is strength: antiviral and anti-inflammatory drugs for COVID-19. Drug Discov Today 2021;26:229–39.
    1. Di Lazzaro V, Capone F, Apollonio F, et al. . A consensus panel review of central nervous system effects of the exposure to low-intensity extremely low-frequency magnetic fields. Brain Stimul 2013;6:469–76.
    1. Robertson JA, Théberge J, Weller J, Drost DJ, Prato FS, Thomas AW. Low-frequency pulsed electromagnetic field exposure can alter neuroprocessing in humans. J R Soc Interface 2010;7:467–73.
    1. Cook CM, Thomas AW, Keenliside L, Prato FS. Resting EEG effects during exposure to a pulsed ELF magnetic field. Bioelectromagnetics 2005;26:367–76.
    1. Rickaby DA, Fehring JF, Johnston MR, Dawson CA. Tolerance of the isolated perfused lung to hyperthermia. J Thorac Cardiovasc Surg 1991;101:732–9.
    1. Cowen ME, Howard RB, Mulvin D, Dawson CA, Johnston MR. Lung tolerance to hyperthermia by in vivo perfusion. Eur J Cardiothorac Surg 1992;6:167–72. discussion 173.
    1. Cohen M. Turning up the heat on COVID-19: heat as a therapeutic intervention. F1000Res 2020;9:292.
    1. Dieing A, Ahlers O, Hildebrandt B, et al. . The effect of induced hyperthermia on the immune system. Prog Brain Res 2007;162:137–52.
    1. Peer AJ, Grimm MJ, Zynda ER, Repasky EA. Diverse immune mechanisms may contribute to the survival benefit seen in cancer patients receiving hyperthermia. Immunol Res 2010;46:137–54.
    1. Sen A, Khona D, Ghatak S, et al. . Electroceutical Fabric Lowers Zeta Potential and Eradicates Coronavirus Infectivity upon Contact. ChemRxiv. Cambridge: Cambridge Open Engage; 2020; This content is a preprint and has not been peer-reviewed. .
    1. Yap TF, Liu Z, Shveda RA, Preston DJ. A predictive model of the temperature-dependent inactivation of coronaviruses. Appl Phys Lett 2020;117:060601.
    1. Ramirez FE, Sanchez A, Pirskanen AT. Hydrothermotherapy in prevention and treatment of mild to moderate cases of COVID-19. Med Hypotheses 2021;146:110363.
    1. 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. Am J Case Rep 2020;21:e926779.
    1. Zang X, Wang Q, Zhou H, Liu S, Xue X. COVID-19 Early Prone Position Study Group. Efficacy of early prone position for COVID-19 patients with severe hypoxia: a single-center prospective cohort study. Intensive Care Med 2020;46:1927–9.
    1. Guibert R, Guibert B. Combined thermotherapy and electrotherapy technique. 1994;number 5,315,994.
    1. Zee J. Heating the patient: a promising approach? Ann Oncol 2002;13:1173–84.
    1. Wust P, Hildebrandt B, Sreenivasa G, et al. . Hyperthermia in combined treatment of cancer. Lancet Oncol 2002;3:487–97.
    1. Chang D, Lim M, Goos JACM, et al. . Biologically targeted magnetic hyperthermia: potential and limitations. Front Pharmacol 2018;9:831.
    1. Lu R, Zhao X, Li J, et al. . Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet 2020;395:565–74.
    1. Chan JF-W, Kok K-H, Zhu Z, et al. . Genomic characterization of the 2019 novel human-pathogenic coronavirus isolated from a patient with atypical pneumonia after visiting Wuhan. Emerg Microbes Infect 2020;9:221–36.
    1. Huang Y, Yang C, Xu X-F, Xu W, Liu S-W. Structural and functional properties of SARS-CoV-2 spike protein: potential antivirus drug development for COVID-19. Acta Pharmacol Sin 2020;41:1141–9.
    1. Min Y-Q, Mo Q, Wang J, Deng F, Wang H, Ning Y-J. SARS-CoV-2 nsp1: bioinformatics, potential structural and functional features, and implications for drug/vaccine designs. Front Microbiol 2020;11:587317.
    1. Yuan S, Peng L, Park JJ, et al. . Nonstructural protein 1 of SARS-CoV-2 is a potent pathogenicity factor redirecting host protein synthesis machinery toward viral RNA. Mol Cell 2020;80:1055–66.e6.
    1. Qiao B, Olvera de la Cruz M. Enhanced binding of SARS-CoV-2 spike protein to receptor by distal polybasic cleavage sites. ACS Nano 2020;14:10616–23.
    1. Kettleson EM, Ramaswami B, Hogan CJ, Jr, et al. . Airborne virus capture and inactivation by an electrostatic particle collector. Environ Sci Technol 2009;43:5940–6.
    1. Leung WWF, Sun Q. Electrostatic charged nanofiber filter for filtering airborne novel coronavirus (COVID-19) and nano-aerosols. Sep Purif Technol 2020;250:116886.
    1. Terunuma H. Potentiating immune system by hyperthermia. Hyperthermic Oncology from Bench to Bedside 2016;Singapore: Springer, 127–135.
    1. Tydings C, Sharma KV, Kim A, Yarmolenko PS. Emerging hyperthermia applications for pediatric oncology. Adv Drug Deliv Rev 2020;163–164:157–67.
    1. Haji Abdolvahab M, Moradi-Kalbolandi S, Zarei M, Bose D, Majidzadeh-A K, Farahmand L. Potential role of interferons in treating COVID-19 patients. Int Immunopharmacol 2021;90:107171.
    1. Ziegler CGK, Allon SJ, Nyquist SK, et al. . SARS-CoV-2 receptor ACE2 is an interferon-stimulated gene in human airway epithelial cells and is detected in specific cell subsets across tissues. Cell 2020;181: 1016-1035.e19.
    1. Man WD-C. Magnetic stimulation for the measurement of respiratory and skeletal muscle function. Eur Respir J 2004;24:846–60.
    1. Similowski T, Fleury B, Launois S, Cathala HP, Bouche P, Derenne JP. Cervical magnetic stimulation: a new painless method for bilateral phrenic nerve stimulation in conscious humans. J Appl Physiol 1989;67:1311–8.
    1. Dominguez-Nicolas SM, Juarez-Aguirre R, Herrera-May AL, et al. . Respiratory magnetogram detected with a MEMS device. Int J Med Sci 2013;10:1445–50.

Source: PubMed

Sponsorer og samarbejdspartnere

Medicinske tilstande

Narkotikainterventioner

3
Abonner