Co-Infection of COVID-19, Influenza and RSV: How Non-pharmaceutical Therapeutic Approaches Such as Low Dose Radiation Therapy Can be A Game Changing Strategy

Non-pharmaceutical interventions (NPIs), such as social distancing, were previously reported to play a significant role in diminishing the transmission of COVID-19. However, updated guidelines highlight the elimination of social distancing, quarantine, and test-to-stay for schools, which may increase the risk of a tripledemic. H3N2, a subtype of influenza type A, has caused waves of infection in the southern hemisphere. A tripledemic of RSV, COVID-19 and influenza viruses can result in the full circulation of the flu and SARS-CoV-2, especially during fall and severe flu season. Moreover, in the presence of the COVID-19 pandemic, the occurrence of recombination within influenza and SARS-CoV-2 can lead to the emergence of new variants. It has been reported that coinfection with these viruses could significantly impact health service demand, morbidity, and mortality. Patients with dual influenza A/SARS-CoV-2 infection may have a more severe illness compared to those with a single infection. Furthermore, as recombination can lead to viral evolution at a quicker rate than mutation, during a tripledemic, recombination may increase the likelihood of developing new variants with higher virulence. As early as March 2020, our research team suggested applying low-dose radiation therapy (LDRT) for patients with COVID-19. Our first report received remarkable global attention, and following this report, numerous papers were published on this topic. Moreover, more than ten clinical trials have been conducted on LDRT for COVID-19 worldwide. The wide spectrum of advantages of using LDRT for treating COVID-19/influenza-associated symptoms is discussed.