Efficacy and safety of short-wave diathermy treatment for moderate COVID-19 patients: a prospective, double-blind, randomized controlled clinical study

Abstract

Background: Millions of human beings have suffered in the epidemic of Coronavirus disease 2019 (COVID-19), but until now the effective treatment methods have been limited.

Aim: This study aimed to evaluate the efficacy and safety of short-wave diathermy (SWD) treatment for moderate COVID-19 patients.

Design: A prospective, double-blind, randomized controlled clinical study.

Setting: Inpatients Unit of a COVID-19 specialized hospital.

Population: Forty-two patients with moderate COVID-19 were randomly allocated at a 2:1 ratio to two groups: the SWD group and the control group.

Methods: Participants of the SWD group received SWD treatment, and participants of the control group received placebo SWD treatment for one session per day, 10 minutes per session, for no more than 14 days. Both groups were given standard care treatment. Primary outcome was the rate of clinical improvement according to a seven-category ordinal scale. Secondary outcomes included the rate of computed tomography (CT) improvement and the rate of potential adverse events.

Results: Clinical improvement occurred in 92.6% of patients in the SWD group by day 14 compared with 69.2% of patients in the control group (P=0.001). The Cox model indicated that the SWD group had a higher clinical improvement probability than the control group (hazard ratio: 3.045; 95% CI: 1.391-6.666; P=0.005). Similarly, CT improvement occurred in 85.2% of patients in the SWD group and 46.2% of patients in the control group respectively by day 14 (P=0.001). The Cox model indicated SWD group had a higher CT improvement probability than control group (hazard ratio: 3.720; 95% CI: 1.486-9.311; P=0.005). There was no significant difference in adverse events between the SWD group and the control group (2 of 27 [7.4%] SWD vs. 1 of 13 [7.7%] control, P=1.000), the most frequent of which were headache (1 of 27 [3.7%] SWD vs. 1 of 13 [7.7%] control patients) and dizziness (1 of 27 [3.7%] SWD vs. 0 of 13 [0%] control patients).

Conclusions: SWD is a valid and reliable adjuvant therapy with a favorable safety profile for moderate COVID-19 patients.

Clinical rehabilitation impact: Clinically relevant information is lacking regarding the efficacy and safety of SWD for patients with COVID-19. This study provides the first evidence that SWD is a promising adjuvant therapy for COVID-19.

Figure 1

—Treatment study flowchart.

Figure 2

—Distribution of patients in the seven-category scale from day 0 to day 14. SWD: short-wave diathermy; ICU: Intensive Care Unit; ECMO: extracorporeal membrane oxygenation.

Figure 3

—Overall rate of clinical improvement among hospitalized patients in the SWD group and the control group.

Figure 4

—Overall rate of CT improvement among hospitalized patients in the SWD group and the control group.

Figure 5

—Representative lung CT before and after SWD treatment. A) Before treatment; B) after treatment.