Potential Utility of Radiopharmaceuticals in the Battle Against SARS-Cov-2 and COVID-19 Pandemic

Coronavirus disease 2019 (COVID-19) pandemic, which has emerged in December 2019 in the city of Wuhan, China, has significantly affected healthcare systems and economies within a short timeframe. Treatment strategies offer alleviation of symptoms in the absence of commercially available specific antiviral agents. Within this context, the introduction of innovative therapeutic approaches against the SARS-CoV-2 virus is a critical need that should be addressed urgently. The anti-inflammatory effect of low dose irradiation has been proposed as a potential therapeutic strategy for COVID-19 pneumonia. Consideration of external beam irradiation for management of COVID-19 pneumonia has prompted the investigation of alternative methods of irradiation with potentially improved toxicity profiles. Theoretically, targeted radiotherapy may have several advantages over conventional external beam radiotherapy owing to the capability to deliver effective radiation doses without adverse irradiation effects. Since radionuclides are conjugated to targeting vectors, such as antibodies and cell surface receptor binding peptides, irradiation may be focused on targeted cells with optimal sparing of surrounding normal tissues. In the context of COVID-19 management, targeted irradiation is expected to compromise SARS-CoV-2 extracellular virions. Targeted radiotherapy may offer a viable means of combating against SARS-CoV-2 virus. There is room for improvement with the need for efficacy, feasibility, and toxicity studies. Although targeted radiotherapy itself may not achieve absolute eradication of virus or virus-infected cells, it may at least serve as a supplementary therapeutic strategy that could be utilized in combination with other antiviral treatments. Further investigations focusing on nuclear medicine, radiopharmaceuticals, and targeted radiotherapy strategies may pave the way for the development of efficacious antiviral treatments which may be utilized in the battle against the current COVID-19 pandemic.