The initial findings from the COVID-19 pandemic from Wuhan China and the United States indicated that many patients admitted to the hospital had either leucopenia, lymphopenia, or both, with the worst cases of lymphopenia found in patients who died.
11,12-14
OMT techniques have been investigated in animal models to assess their effects on immune cell populations. LPT performed on dogs was shown to increase leukocyte count when analyzed by flow cytometry, with similar increases seen in all leukocyte populations.
6 Studies conducted on both dogs and rats showed that LPT enhanced the immune response by mobilizing increased levels of inflammatory cytokines, increasing lymph flow, and increased leukocyte counts in the thoracic duct lymph.
6,15,16 Hodge et al
17 showed that these leukocytes were recruited from the gut-associated lymphoid tissue and were transported in the lymph during the use of LPT, but the effects were transient. This finding is important because this is where 70% to 80% of plasma cells in the human body are normally located. The number of leukocytes went from a resting state of approximately 5 million cells per minute to 150 million cells per minute while the dogs received LPT. Further investigation into these animal models showed that LPT can produce the same beneficial results multiple times, including increased lymphatic flow, leukocyte recruitment, and cytokine/chemokine flux.
18 This movement of immune cells to other areas of the body may help boost insufficient immune responses to fight off viral infections. A study
19 investigating the effect of ALP on the delivery of antibiotics in rats infected with
Streptococcus pneumoniae demonstrated enhanced delivery and greater effectiveness, with 63% of rats free of disease when OMT was combined with antibiotics vs 25% when antibiotics and saline were administered without OMT. ALP, independent of antibiotics, still had the ability to make 13% of rats disease free at the end of the study when compared with 0% disease-free rats in the control/saline and sham/saline groups.
19
One major complication of COVID-19 is the long length of hospital stays, with patients who will eventually recover staying a median length of 10 to 13 days.
13,20,21 In a randomized controlled clinical trial conducted by Noll et al,
8 elderly patients treated with OMT for pneumonia had significantly shorter hospital stays and shortened duration of intravenous medication. In another randomized clinical trial, Noll et al
9 found that patients hospitalized with pneumonia and treated with OMT had significantly reduced length of hospitalizations, intravenous antibiotics, mortality, and respiratory failure when compared with conventional care only. This study, however, found no significant differences in intention-to-treat analysis or between light touch and OMT. Unfortunately, neither of these studies used ALP, which is arguably the most effective technique for mobilizing the immune system to mount a more effective response to an invading pathogen.
5,6
Another unique advantage OMT may have is the ability of the body to respond to a vaccine more effectively. In a clinical trial, Jackson et al
7 saw an increase in hepatitis B titer in patients treated with OMT when compared with a control group (no OMT), who also received the vaccine. This finding suggested improved immune function with OMT, which may be useful when a vaccine is made available to the public.