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The COVID-19 pandemic will be remembered for its significant health and economic impact worldwide. Severe pneumonia could often progress to acute respiratory distress syndrome (ARDS), this being a critical complication characterised by an exaggerated inflammatory response, known as cytokine-release syndrome (CRS). Amid debates regarding the efficacy of conventional treatments, low-dose Radiotherapy (LDRT) has emerged as a potential therapy due to its anti-inflammatory effects. LDRT modulates immune responses by polarizing macrophages towards an anti-inflammatory phenotype and reducing oxidative stress. While studies investigating LDRT for COVID-19 pneumonia have shown promising results, conflicting data has been published and challenges persist in patient selection and treatment timing. Biomarkers such as paraoxonase-1 activity hold promise for predicting treatment outcomes. LDRT presents an alternative approach to modulating the immune response in COVID-19 pneumonia, offering hope for improved clinical outcomes. Further research is warranted to validate its efficacy and elucidate underlying mechanisms.

This article provides summary of the radioimmunological mechanisms and the results of biomarkers research in this context.