Coronavirus disease (COVID-19) is a pandemic of unprecedented proportions with an exponential increase in incidence. Airway epithelium infection caused by coronavirus (SARS-CoV-2) triggers a cascade of difficult-to-control reactions, a so-called "cytokine storm". In contrast to the previously used method of external beam radiation therapy for patients at high risk of a cytokine storm, in present study a different dose delivery mechanism through inhalation of 99mTc-labeled carbon ultrafine aerosol obtained from a TechnegasPlus generator is used. By utilizing anthropometric phantoms the dosimetric characteristics of the applied technique and obtained the coefficients of the transition from the count rate over the area of interest to the activity contained in this area (in kBq) were studied. By observing a group of healthy volunteers after inhalation of 99mTc-labeled carbon ultrafine aerosol, the accumulated dose in the human lungs under internal irradiation of 99mTc was determined. A novel technique has been developed and the possibility of using inhaled low-dose radionuclide therapy in the complex treatment of patients with COVID-19 - associated pneumonia has been studied. As a result, a significant improvement of hematological parameters in the group of patients after inhalation of 99mTc-labeled carbon ultrafine aerosol as compared to the control group is expected.
Radiation: 99mTc-pertechnetate aerosol
99mTc-pertechnetate is 99mTc-labeled carbon ultrafine aerosol
Drug: 99mTc-pertechnetate aerosol
99mTc-pertechnetate is 99mTc-labeled carbon ultrafine aerosol
Inclusion Criteria:
1. Positive SARS-Cov-2 polymerase chain reaction (PCR)
2. CT confirmed pneumonia
3. Men and non-pregnant women ≥ 18 y/o with early laboratory signs of cytokine storm
4. Men and non-pregnant women <65 y/o and/or with early laboratory signs of cytokine
storm
5. Informed consent obtained for participation
Exclusion Criteria:
1. Age ≤ 18
2. Severe course of COVID-19
3. Pregnant or breast-feeding females
4. Severe concomitant pathology
5. Previous and/or present treatment of oncology disease (e.g. immunotherapy)
6. Autoimmune diseases, severe cardiac disease, bone marrow and/or visceral
transplantation
7. Surgical treatment and/or radiotherapy of chest pathology
8. Treatment with specific antiviral and anticytokine agents a day before inhalation
procedure
9. Absence of informed consent obtained for participation
P. Hertsen Moscow Oncology Research Institute
Moscow, Russian Federation