We have all either had COVID ourselves or had a loved one affected by the pandemic. Of those that have had COVID, approximately 30% struggle with continuing symptoms also known as Long-COVID or Post-COVID Conditions. The prolonged symptoms have been reported to last anywhere from 4 weeks to years. These symptoms have become such an issue that the United States has launched a national research action plan for Long-COVID. This has led to the investigation of therapies for those still struggling with symptoms (AL. Cabrera et al., 2021).
According to the Center for Disease Control (CDC), the symptoms most reported include, neurocognitive impairment and fatigue, hypoxia, continuous inflammatory response, among others. However, the most common symptom is fatigue. Of all long-COVID patients, 65% reported fatigue impacting normal daily functions (AL. Cabrera et al., 2021). The resulting fatigue is a very difficult symptom to treat, however there are similarities between this COVID induced symptom and chronic fatigue syndrome.
Hyperbaric oxygen therapy (HBOT) involves intermittent inhalation of 100% oxygen under pressure greater than one atmosphere. There have been studies which demonstrated improvement of symptoms of chronic fatigue syndrome (CFS) (Akarsu S., et al., 2013). These studies have led researchers to look at HBOT for Long-COVID symptoms.
UK researcher, Tim Robbins, led the first known clinical investigation of HBOT for long-COVID, with promising results. The study demonstrated that once daily HBOT for 10 consecutive days yielded statistically significant improvement in fatigue scales, cognition, executive function, attention, information processing, and verbal function (Robbins, T. et al., 2021). This research proved to be critical initial evaluation of HBOT for long-COVID symptoms. The research also served as a foundation for another research group to further elucidate the possible benefits of HBOT for long-COVID.
The most recent investigation was conducted at Sagol Center for Hyperbaric Medicine and Research at Shamir Medical Center and Tel Aviv University. The study is the first randomized controlled trial exploring treatment of long-COVID symptoms with HBOT. The study consisted of patients that had post-COVID symptoms for at least three months post initial infection. Treatment groups consisted of 36 patients receiving HBOT and 36 patients in the control group. Data was collected in several areas including qualitative questionnaire information (anxiety, fatigue, and depression scales), sleep scores, brain physiology and oxygen perfusion, odor detection, and sense of taste (Zilberman‐Itskovich S., et al., 2022).
Long-COVID has been associated with neuronal injury of the frontal lobe. Therefore, the study went into depth by correlating symptom improvement with brain function via MRI and brain microstructure scans. It was demonstrated that the psychiatric and cognitive symptoms were associated with microstructural changes in the frontal lobe and limbic regions (Zilberman‐Itskovich S., et al., 2022).
This study yielded may positive results indicating that HBOT is a valid treatment for Long Covid. This fact is particularly true for symptoms including psychiatric symptoms (depression and anxiety), brain fog, and fatigue. It also gives us a new perspective as to how brain structure changes during COVID as well as how HBOT can aid in the regenerative process of the brain (Zilberman‐Itskovich S., et al., 2022).
With so much of the population effected by Long-COVID, there is a great need for treatment options. There are still very limited treatments for overall fatigue and cognitive function, however HBOT provides a bit of hope for those experiencing the detrimental effects of these symptoms. At MedHouse and R3 Health, we are here to design treatment plans to help those patients that may be experiencing these continuing symptoms of Long-COVID.
Akarsu S, Tekin L, Ay H et al. The efficacy of hyperbaric oxygen therapy in the management of chronic fatigue syndrome. Undersea Hyperb Med 2013; 40:197–200
Cabrera Martimbianco AL, Pacheco RL, Bagattini ÂM, Riera R. Frequency, signs and symptoms, and criteria adopted for long COVID-19: A systematic review. Int J Clin Pract. 2021.
Robbins, T. et al., Hyperbaric oxygen therapy for the treatment of long COVID: early evaluation of a highly promising intervention. Clin Med November 2021.
Zilberman‐Itskovich S., et al., Hyperbaric oxygen therapy improves neurocognitive functions and symptoms of post‐COVID condition: randomized controlled trial. Nature 2022; 12:11252.
