HBOT and Long Covid
As of January 2022,the severe acute respiratory syndrome Corona Virus 2 (SARS-CoV-2) pandemic has resulted in more than 300 million infected cases. Even though most infected patients recover, 10-30% remain with persistent symptoms that have devastating effects on their quality of life. The World Health Organization has recognized this clinical condition and defined it as post-Covid-19 condition. This condition is confirmed three months from the onset of Covid-19 with having physical, neurocognitive and psychiatric symptoms that persist for more than two months and cannot be explained by ah alternative diagnosis. Neurocognitive and psychiatric symptoms include decreased executive functions, anxiety, depression and post traumatic stress symptoms. Most common physical symptoms include fatigue, dyspnea, ageusia, anosmia, insomnia, headaches and systemic widespread pain.
The pathogenesis of post-Covid-19 condition is not yet determined. Suggested mechanisms include direct brain invasion of the virus, dysregulated immunologic responses, thrombotic desease, mitochondrial dysfunction and vascular imjury with secondary tissue hypoxia. Currently studied treatment options of post-Covid-19 condition are targeted anti-inflammatory molecules, specific diets and cognitive behavioral therapy. However, none have been determined effective.
In recent years, evidence has been accumulated about the neuroplasticity effects of hyperbaric oxygen therapy(HBOT). It is now realized, that combined action of hyperoxia hyperbaric pressure, leads to significant improvement in tissue oxygenation while targeting both oxygen and pressure sensitive genes. Preclinical and clinical studies have demonstrated several neuroplasticity effects including anti-inflammatory, mitochondrial function restoration, increased perfusion via angiogenesis and induction of proliferation and migration of stem cells.
Randomized controlled trail in Israel, published on 12 July, 2022 shows how Hyperbaric oxygen therapy (HBOT)can improve neurocgnitive functions and symptoms of post-Covid-19condition.
In conclusion, HBOT can improve dysexecutive functions, psychiatric symptoms(depression, anxiety and somatization), pain interference symptoms and fatigue of patients suffering from post-Covid-19 condition. The beneficial effects can be attributed to increased brain perfusion and neuroplasticity in regions associated with cognitive and emotional roles.