Hyperbaric Oxygen Therapy : An Effective Treatment for Long Covid?

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Last Reviewed on August 5, 2022 by Alice Pien, MD & Asher Milgrom, PhD

2 Sechrist H-Series Monoplace Hyperbaric Chambers. The H-Series Hyperbaric Oxygen Chambers are the most advanced chambers in the world. They are also spacious, providing the ability for the patient to rest in a reclined or angled position for better comfort.

Pictured above are 2 Sechrist H-Series Monoplace Hyperbaric Chambers. The H-Series Hyperbaric Oxygen Chambers are the most advanced chambers in the world. They are also spacious, providing the ability for the patient to rest in a reclined or angled position for better comfort. We have 3 of these chambers at our clinic.

New scientific research into the benefits of hyperbaric oxygen therapy (HBOT) as a treatment for Long Covid is producing statistically significant results. Clinical trials and case studies have shown improvements in cognitive functioning (brain fog), physical capacity, breathing and fatigue just to name a few. Thanks to this new research and several other clinical trials currently in progress, HBOT is quickly becoming one of the top treatment options for Covid Long Haulers.  

Explore the photos above to get an in-depth view inside the hyperbaric chamber.

In our clinic at AMA Regenerative Medicine & Skincare we have seen this first hand. Many patients report that their neurological issues, the headaches and the throbbing migraines and the pounding cluster headaches begin to feel relieved even after their first treatment in the hyperbaric chamber.

Overview of Long Covid

Watch the video : What is Long Covid and How to Treat it

Covid-19 itself is still a relatively unknown disease. While significant advances have been made regarding the virus’s origination, method of infection, and disease course, there is still very little understood about the recently termed “Long Covid” (AKA Long-Haul Covid, Post Covid Syndrome, Post-acute Covid-19 Syndrome, Long Covid Syndrome), primarily because it is impossible to gauge how a newly originated condition can affect individuals long-term.

Long Covid, at its most basic explanation, is a condition where individuals continue to experience symptoms (and many times experience completely new symptoms) for weeks, months and even years following infection with the Covid-19 virus. Some people get the virus, get sick and stay sick. Some people get the virus, recover and then 2, 3, 4 months later come down with an entirely new set of symptoms. In both cases, these symptoms persist for a long time. 

What Causes Long Covid

The exact cause of Long Covid is still relatively unknown. The silver lining of this pandemic is that a lot of research is going into understanding the cause of chronic viral infections. 

However, researchers suspect that Long Covid and its symptoms result from pathological inflammation and long-term tissue damage (to the brain, lung, heart, etc). This inflammation results from viral persistence, autoimmunity, and immune dysregulation. The inflammation leads to long-term tissue damage and that is when the symptoms of Long Covid appear.

The micro-vasculature becomes so inflamed that the blood can no longer flow causing tissue damage.

The micro-vasculature becomes so inflamed that the blood can no longer flow, oxygen can no longer be delivered, Co2 can no longer be removed and the tissue of that organ becomes damaged. 

Studies investigating the prevalence of Long Covid are relatively small, but they suggest that around one-third of patients not hospitalized with Covid-19 do not experience a full recovery and end up with symptoms that persist longer than 2-6 weeks from disease onset. Some studies put that number at 50% of patients.

Furthermore, 11%-24% of cases still report symptoms 3 months following the onset of the disease.

And still others report that they have endured the symptoms of Long Covid for a year or more. 

Risk Factors of Long Covid

One would expect that those who had a severe case of Covid-19 would be more likely for their infection to transition into Long Covid. But that is NOT the case. Many people who end up with Long Covid report that they had a very mild case of Covid-19.

Some potential risk factors for Long Covid include:

  • Being female
  • Early dyspnea
  • More than five early symptoms
  • Specific biomarkers (e.g., lymphocyte count)
  • Prior psychiatric disorders

It is important to note that these are potential risk factors and additional evidence is still needed for confirmation. However, they serve as a starting point for assessing risk.

Common Symptoms of Long Covid

There are over 200 symptoms associated with Long Covid. The most common being brain fog and memory impairment, postural orthostatic tachycardia syndrome (POTS), chronic fatigue, shortness of breath and heart palpitations.

Additional persisting symptoms associated with long COVID include (this is not even close to a complete list):

  • Anxiety
  • Bladder control problems
  • Blood clots
  • Blurred vision
  • Changes to the menstrual cycle
  • Chest pain
  • Chills
  • Constipation
  • Diarrhea
  • Digestive Disorders
  • Dizziness
  • Elevated heart rate
  • Eye infections
  • Headache
  • Heart palpitations
  • Hypertension
  • Itchy skin
  • Limb edema
  • Loss of taste
  • Low blood pressure
  • Memory loss
  • Mood changes
  • Mouth sores
  • Muscle pain
  • Myocarditis
  • Nausea
  • Paranoia
  • PTSD
  • Rapid breathing
  • Rash
  • Renal failure
  • Ringing in the ears (tinnitus)
  • Sexual dysfunction
  • Shingles
  • Sleep apnea
  • Sleep problems
  • Tremors
  • Twitchy muscles
  • Visual hallucinations

As evident from this extensive list, Covid Long Haulers experience a significant diminishing of their quality of life for months and even years after initially contracting the virus.

Some patients experience residual symptoms and others develop completely new symptoms long after the initial infection. As you can see from the list above these symptoms can present across a wide range of organ systems and tissues.

Overview of Hyperbaric Oxygen Therapy

A patient relaxes in a hyperbaric oxygen chamber. The mask she is wearing is supplying her with pure oxygen.

A patient relaxes in a hyperbaric oxygen chamber. The mask she is wearing is supplying her with pure oxygen.

Hyperbaric oxygen therapy (HBOT) is not a new procedure, with its first documented use in 1662. Granted, the technology of HBOT has advanced significantly since the 17th century. The long list of benefits HBOT produces have been observed over hundreds of years and new benefits are regularly being discovered. For instance, its application and therapeutic ability to treat Long Covid.

HBOT itself is a therapeutical approach that involves exposing the patient to pure oxygen under increased atmospheric pressure. Specifically, patients enter a hyperbaric chamber that is typically pressurized to 2 atmospheres (atm) and while in the chamber the patient is breathing pure oxygen.

HBOT is an FDA approved treatment for many conditions, including severe anemia, air embolism, idiopathic sensorial hearing loss and certain infectious diseases. It is this last approval that makes HBOT appealing for the treatment of Long Covid.

HBOT is also commonly used, in what the FDA considers “off-label use”, for a number of conditions and diseases including lyme disease, multiple sclerosis, post traumatic stress disorder, recovery following surgery, traumatic brain injury, autism and many, many others.

The Importance of Oxygen

Oxygen is well-known as essential for survival. Oxygen plays a critical role in the ability of cells to complete aerobic respiration, an action that takes place in the mitochondria. Oxygen leads to ATP synthesis during the process of oxidative phosphorylation, with ATP being an energy source. So, when the body is lacking oxygen, it does not produce enough energy to carry out important body functions.

Every cell has mitochondria. Mitochondria create ATP which is the chemical fuel that every cell in your body needs to function.

Every cell has mitochondria. Mitochondria create ATP which is the chemical fuel that every cell in your body needs to function.

Hypoxia, or a lack of oxygen in the blood, induces pathological stress in the cells that is closely related to a range of diseases. Because of this, HBOT is a beneficial treatment due to its ability to deliver oxygen to every nook and cranny of the body.

There are three factors that contribute to the success of HBOT:

1) 100% Oxygen Concentration

The transfer of oxygen from the air we breathe to the bloodstream occurs due to concentration gradients. The air is rich in oxygen, while deoxygenated blood is poor in oxygen. This creates a gradient from lungs to blood, supplying the blood with oxygen that the heart then pumps to the rest of the body.

By breathing in 100% pure oxygen, a positive gradient is created, which significantly helps with the transfer from air to blood.

2) Blood O2 Concentration Raises

Being in a hyperbaric chamber under pressure raises the O2 concentration in the blood, as described by Henry’s law. Essentially, a liquid’s partial pressure is directly proportional to the amount of dissolved gas. So, when the partial pressure is increased, the oxygen concentration dissolved in the blood also increases.

3) Decreases Gas Bubble Size

According to Henry’s law and the Boyle-Mariotte Law (Boyle’s Law), when pressure increases, the size of the gas bubbles will decrease, making it easier for oxygen to travel through tissue.

All three of these components result in an environment that significantly increases oxygen concentration in the blood while also increasing the likelihood of this oxygen transferring to the tissues. Simply stated, the increased pressure causes the oxygen to dissolve in all the fluids of your body so that every single cell, in every single tissue, in every single organ, becomes super saturated with oxygen.

Research-Based Benefits of Hyperbaric Oxygen Therapy for Long Covid

Watch the video : How I Recovered from Long Covid with EBOO and HBOT

Emerging studies and clinical trials regarding hyperbaric oxygen therapy for Long Covid are finding that HBOT is able to address the unpleasant symptoms that persist for months and even years after the initial infection.

Chronic Fatigue

A study on ten patients found that hyperbaric oxygen therapy was able to relieve fatigue in Covid Long Haulers. Participants in the study received 10 sessions of HBOT at 2.4 atm over the course of 12 days. Each session lasted for 105 minutes, with three 30-minute periods of 100% oxygen exposure, followed by a 5-minute air break.

The results show significant improvements in the Chalder fatigue scale, global cognition, executive function, attention, information processing, and verbal functioning.

 

Scores between day 1 (before) and day 10 (after) of hyperbaric oxygen therapy. * = significant difference.

Scores between day 1 (before) and day 10 (after) of hyperbaric oxygen therapy. * = significant difference.

These results suggest that HBOT may be able to improve the wellbeing and quality of life of Covid Long Haulers. These benefits can be especially appealing for individuals experiencing significant setbacks in their work and personal life due to fatigue and other mental impairment conditions such as brain fog.

Cognitive Impairments / Brain Fog

A case study on a previously healthy 55-year-old man presenting with Long Covid 3 months after his initial infection with Covid-19 brings to the forefront the benefits of hyperbaric oxygen therapy for cognitive functioning.

The male underwent HBOT at 2 atm for 60 sessions. Each session was for 90 minutes, rotating through a cycle of 20 minutes of 100% oxygen and 5 minutes of normal air. The sessions were performed 5 days a week.

At the end of the subject’s sessions, the MRI evaluation showed significant improvements in brain perfusion and microstructure, producing improvements in cognitive functioning.

Brain perfusion magnetic resonance imaging before and after hyperbaric oxygen therapy. The upper row represents brain perfusion 3 months after the Covid infection, before HBOT. The lower row represents the perfusion magnetic resonance imaging done after completing the HBOT protocol.

Brain perfusion magnetic resonance imaging before and after hyperbaric oxygen therapy. The upper row represents brain perfusion 3 months after the Covid infection, before HBOT. The lower row represents the perfusion magnetic resonance imaging done after completing the HBOT protocol.

These improvements include improved executive functions, cognitive flexibility, nonverbal memory, attention, multitasking, and information processing speed. MRI scans also observed increased blood flow to brain regions responsible for these actions, which correlates with the observed improvements.

Shortness of Breath

With how Covid-19 attacks the respiratory system, many Covid Long Haulers are left experiencing shortness of breath as their respiratory system struggles to recover from the damage created by the virus. However, HBOT appears to be the solution.

The same case study on the 55-year-old man, as discussed above, also observed improvements in his breathing. There was a 34% increase in the maximum amount of oxygen consumed when exercising and a 44% improvement in forced vital capacity. These results show quantitative improvements in the respiratory system, which address the symptom of shortness of breath.

More Clinical Trials Currently Underway

Several clinical trials are underway to definitively prove the effectiveness of hyperbaric oxygen therapy in the treatment of Long Covid.

Hyperbaric Oxygen for Long Covid-19 Pulmonary Sequela

This clinical trial is an open, randomized, controlled pilot study focused on the lingering pulmonary symptoms of Long Covid. 24 Covid Long Haulers will be randomized and receive 12 treatments in the hyperbaric oxygen chamber. 12 patients receiving the treatments and 12 patients serving as control and not receiving the treatments (sham treatment).

Their hypothesis is that the pulmonary symptoms are caused by lingering inflammatory processes causing pulmonary gas exchange derangement. HBOT is known to have anti-inflammatory effects. If the pulmonary symptoms are indeed caused by lingering inflammatory processes then HBOT should be able to reduce the inflammation and therefore eliminate the pulmonary symptoms.

Safety and Efficacy of Hyperbaric Oxygen Therapy for Long Covid Syndrome (HOT-LoCO)

This next trial is a randomized, placebo-controlled, double blind, phase II, clinical trial to study if hyperbaric oxygen therapy will alleviate the symptoms of Long Covid.

80 Covid Long Haulers will be randomized, some receiving treatment and some receiving a sham treatment. Efficacy of the treatment will be evaluated at 3 months post treatment to see which symptoms of Long Covid were alleviated and / or eliminated.

Hyperbaric Oxygen Therapy for Post-Covid-19 Syndrome (HBOTpCOVID)

The purpose of this clinical trial is to compare the effect of hyperbaric oxygen therapy versus sham treatment in reducing Long Covid symptoms such as cognitive impairment, fatigue, sleep disorders, smell and taste disorders, pain and other neurologic symptoms. 

They believe that an uncontrolled inflammatory response, called cytokines storm, is causing neuroinflammation. Also, that a hypercoagulability state accompanies acute infection that leads to small and large vessel occlusion. All of which are important causes of local hypoxia. Hyperbaric oxygen therapy is known to reverse hypoxia, reduce neuroinflammation and induce neuroplasticity.

The protocol will include 40 daily sessions at 2 atm for 90 minutes with 5 minute air breaks every 20 minutes.

Long Covid Treatment with Hyperbaric Oxygen Therapy

Watch the video : Long Covid Patient’s Life Changed by Hyperbaric Oxygen Therapy

Hyperbaric oxygen therapy is a safe treatment option that can provide immense benefits for those suffering from Long Covid. Long Covid is a side effect of Covid-19 infection where individuals are experiencing symptoms characteristic of Covid-19 infection weeks, months and even years after the initial onset of symptoms. Many young and previously healthy individuals suffer tremendously from Long Covid, seeing a significant impact on their work and personal lives.

 

HBOT involves breathing in 100% oxygen in a high-pressure chamber. This process offers three benefits:

  1. It supplies a greater oxygen gradient.
  2. Increases the oxygen concentration in every nook and cranny of the body.
  3. Makes the oxygen molecules smaller.

All three of these actions result in more effortless gradation from lungs to blood to tissues, treating hypoxia which is often associated with the negative symptoms of Covid-19.

 

Studies, trials and news reports on hyperbaric oxygen therapy being successfully used in the treatment of Long Covid are emerging at a rapid rate. Unfortunately, further research is required before this treatment becomes standard-of-care for the industrial medical complex.

Fortunately, these studies and trials combined with countless reports from integrative physicians, patient testimonials and our own experience treating patients with Long Covid proves, in our mind, that hyperbaric oxygen therapy is an effective treatment for Long Covid.

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References

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