A combinatorial approach of a polypharmacological adjuvant 2-deoxy-D-glucose with low dose radiation therapy to quell the cytokine storm in COVID-19 management

Int J Radiat Biol. 2020 Nov;96(11):1323-1328. doi: 10.1080/09553002.2020.1818865. Epub 2020 Oct 6.


COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a pandemic disease and is the major cause of deaths worldwide. The clinical complexities (inflammation, cytokine storm, and multi-organ dysfunction) associated with COVID-19 poses constraints to effective management of critically ill COVID-19 patients. Low dose radiation therapy (LDRT) has been evaluated as a potential therapeutic modality for COVID-19 pneumonia. However, due to heterogeneity in disease manifestation and inter-individual variations, effective planning for LDRT is limited for this large-scale event. 2-deoxy-D-glucose (2-DG) has emerged as a polypharmacological agent for COVID-19 treatment due to its effects on the glycolytic pathway, anti-inflammatory action, and interaction with viral proteins. We suggest that 2-DG will be a potential adjuvant to enhance the efficacy of LDRT in the treatment of COVID-19 pneumonia. Withal, azido analog of 2-DG, 2-azido-2-DG can produce rapid catastrophic oxidative stress and quell the cytokine storm in critically ill COVID-19 patients.

Keywords: 2-azido-2-deoxy-D-glucose; 2-deoxy-D-glucose (2-DG); COVID-19; Low dose radiation therapy (LDRT); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Betacoronavirus*
  • COVID-19
  • Combined Modality Therapy
  • Coronavirus Infections / immunology
  • Coronavirus Infections / metabolism
  • Coronavirus Infections / therapy*
  • Cytokine Release Syndrome / therapy*
  • Deoxyglucose / pharmacology
  • Deoxyglucose / therapeutic use*
  • Humans
  • Pandemics
  • Pneumonia, Viral / immunology
  • Pneumonia, Viral / metabolism
  • Pneumonia, Viral / therapy*
  • Radiotherapy Dosage
  • SARS-CoV-2


  • Deoxyglucose