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Purpose: To empirically confirm the utility of photobiomodulation (PBM) in the treatment of acute and long COVID-19 guided by a mechanistic analysis of the photochemical effects of pulsed light on SARS-CoV-2 infections and disease progression. Background: COVID-19 comprises a coronavirus severe inflammatory disease infecting tissue populated by ACE-2 receptors of the upper and lower respiratory tract and AEC causing an overexpression of pro-inflammatory cytokines. Once in the lungs, viremic spread and cytokine profusion progresses into multi-organ hyperinflammation of visceral epithelium, vascular endothelium, and neurons of the CNS, PNS, ANS, and brain with long-term sequelae. In response to an oxidative state, red and NIR PBM down-regulates proinflammatory cytokines, activating M2 macrophages and Th2 helper cells to increase anti-inflammatory immune response in accordance with a biphasic dose response. Published reports confirm efficacious therapy of COVID-19 using conformal LED pads or scanned lasers. Results: A series of two acute COVID case studies comprising 69 ambulatory (stage 1-to-5) and five stage-6 hospitalized patients confirm the efficacious impact of whole-organ deep-tissue PBM using algorithmically-pulsed conformal LED pad optical delivery methods. Together, acute symptomatic recovery from two 64-84 min PBM sessions occurred within three days for 62/62 patients. Full recovery occurred within four sessions for all PBM patients (all but two cases resolved within one week). Prophylactic benefits were recorded in 17/17 asymptomatic-to-mild (stage 0-1) patients exposed to viral shedding of infected family members. PBM of long COVID outcomes include total resolution of dyspnea, ability to maintain SpO2 above 97% without oxygen supplementation, relief from digestive distress, elimination of brain fog, improved memory recall, restored executive function, and symptomatically managing emotional deficits. Total whole-organ PBM treatments to date comprise approximately three-hundred fifty cases comprising 60% acute COVID-19, 20% metabolic and respiratory long COVID, and 20% neurological long COVID. Unresolved cases totaling 0.25% include two cases of severe long COVID anxiety and nosophobia where PBM was found to deliver only short-term palliative relief. Conclusion: Ongoing results increasingly support the application of whole-organ deep tissue PBM in the treatment of acute and long COVID-19. Both conformal LED pads and scanning lasers demonstrate favorable outcomes. LED pads deliver higher fluences than scanned lasers in the same session times. Further studies of the prophylactic benefits of PBM are indicated.
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