Hyperbaric Oxygen Therapy (HBOT) is a medical treatment involving breathing pure oxygen within a pressurized chamber. This increases oxygen absorption and delivery throughout the body. Long COVID, also known as post-COVID-19 condition, is a chronic illness with symptoms persisting for at least three months after a SARS-CoV-2 infection. This condition affects multiple organ systems. Researchers are exploring HBOT as a potential therapeutic approach for this persistent and often debilitating condition.
How Hyperbaric Oxygen Therapy Addresses Long COVID
Hyperbaric Oxygen Therapy is thought to alleviate Long COVID symptoms through several physiological mechanisms. The increased pressure and high oxygen concentration in the chamber lead to higher levels of oxygen dissolved in the blood plasma, enhancing its delivery to tissues that may be deprived of adequate oxygen, addressing tissue hypoxia.
HBOT also demonstrates anti-inflammatory effects by influencing the body’s immune response. It can reduce the production of pro-inflammatory cytokines, such as IL-1, IL-6, and TNF-α, while elevating anti-inflammatory cytokines like IL-10. This modulation of inflammatory pathways is relevant since chronic inflammation is considered a characteristic of Long COVID. Additionally, the therapy promotes the synthesis of growth factors and mobilizes stem cells, which are crucial for tissue repair and regeneration.
The therapy’s benefits extend to cellular energy production and nervous system function. HBOT can improve mitochondrial function, which is significant as COVID-19 infection may disrupt these cellular powerhouses. Furthermore, it is believed to induce neuroplasticity, the brain’s ability to reorganize and form new neural connections, potentially aiding in the repair of brain tissue damaged by the virus. This combination of enhanced oxygen delivery, reduced inflammation, tissue repair, and neuroplastic support forms the scientific basis for HBOT’s potential in Long COVID.
Current Research on Hyperbaric Oxygen Therapy for Long COVID
Current scientific investigations into Hyperbaric Oxygen Therapy for Long COVID have shown promising results across various symptoms. Several studies, including randomized controlled trials, have reported improvements in cognitive function, such as brain fog, attention, executive function, and memory. For instance, one randomized, placebo-controlled trial involving 73 Long COVID patients found positive changes in attention, sleep quality, pain symptoms, and energy levels among those who received HBOT. A follow-up study indicated that these clinical improvements could persist even a year after the last HBOT session.
Research also highlights HBOT’s effect on fatigue, a common and debilitating Long COVID symptom. Improvements in sleep quality and pain patterns have also been noted. Some findings suggest that HBOT can improve psychiatric symptoms like anxiety and depression, and enhance overall quality of life.
Beyond neurological and systemic symptoms, HBOT has shown potential in improving cardiopulmonary function in Long COVID patients. Imaging studies, such as MRI scans, have revealed improvements in brain perfusion and microstructural changes, supporting the observed cognitive benefits. While these findings are encouraging, ongoing large-scale studies are still needed to establish precise indications and standardized protocols for HBOT in Long COVID.
Practical Considerations and Safety
Undergoing Hyperbaric Oxygen Therapy typically involves sessions in a specialized chamber. These chambers can be monoplace, designed for one person, or multiplace, accommodating several individuals. During a session, which usually lasts between 60 to 90 minutes, patients breathe 100% oxygen while the pressure inside the chamber is increased to 1.5 to 3 times higher than normal atmospheric pressure. A common treatment course for Long COVID may involve 20 to 40 sessions.
While generally considered safe, HBOT carries potential side effects. Patients may experience discomfort due to pressure changes, similar to what is felt during airplane descent, leading to ear pain or a popping sensation. Other possible side effects include temporary changes in vision, such as nearsightedness, and sinus congestion or pain. Some individuals might feel fatigue or lightheadedness after a session.
Rare but more serious complications can include oxygen toxicity, which may manifest as seizures, or lung damage. Claustrophobia can also be a concern for some patients due to the enclosed nature of the chambers. Strict protocols, medical supervision, and trained staff ensure safety, including prohibiting flammable materials within the chamber. HBOT is not suitable for everyone; contraindications include certain lung diseases, a collapsed lung, a cold or fever, and recent ear surgery.