Hyperbaric Oxygen Therapy Counters Oxidative Stress/Inflammation-Driven Symptoms in Long COVID-19 Patients: Preliminary Outcomes

Abstract

Long COVID-19 patients show systemic inflammation and persistent symptoms such as fatigue and malaise, profoundly affecting their quality of life. Since improving oxygenation can oppose inflammation at multiple tissue levels, we hypothesized that hyperbaric oxygen therapy (HBOT) could arrest inflammation progression and thus relieve symptoms of COVID-19. We evaluated oxy-inflammation biomarkers in long COVID-19 subjects treated with HBOT and monitored with non-invasive methods. Five subjects (two athletes and three patients with other comorbidities) were assigned to receive HBOT: 100% inspired O2 at 2.4 ATA in a multiplace hyperbaric chamber for 90 min (three athletes: 15 HBOT × 5 days/wk for 3 weeks; two patients affected by Idiopathic Sudden Sensorineural Hearing Loss: 30 HBOT × 5 days/wk for 6 weeks; and one patient with osteomyelitis: 30 HBOT × 5 days/wk for week for 6 weeks and, after a 30-day break, followed by a second cycle of 20 HBOT). Using saliva and/or urine samples, reactive oxygen species (ROS), antioxidant capacity, cytokines, lipids peroxidation, DNA damage, and renal status were assessed at T1_pre (basal level) and at T2_pre (basal level after treatment), and the results showed attenuated ROS production, lipid peroxidation, DNA damage, NO metabolites, and inflammation biomarker levels, especially in the athletes post-treatment. Thus, HBOT may represent an alternative non-invasive method for treating long COVID-19-induced long-lasting manifestations of oxy-inflammation.

Physiology of deep closed circuit rebreather mixed gas diving: vascular gas emboli and biological changes during a week-long liveaboard safari

“…Also, maintaining IL-6 levels in a physiological range is necessary to keep inflammatory responses under control ( Stoner et al, 2013 ). Since, the expression of IL-6 is mainly regulated by the activation of NF-κB ( Brasier, 2010 ), which is dependent on oxygen levels and ROS production, we can hypothesize that the oxy-inflammation is at the system’s core of decompression ( Brizzolari et al, 2023 ; Mrakic-Sposta et al, 2023 ; Vezzoli et al, 2024 ). This hypothesis is also supported by the 8-iso-PGF2 increase, which depends on the availability of hydroxyl radicals and by neopterin measurements.…”

Hyperbaric oxygen effectively addresses the pathophysiology of long COVID: clinical review

“…The data showed reduction of ROS production, lipid peroxidation and DNA damage. There was a reduction of nitric oxide metabolites and inflammatory biomarkers ( 28 ). The results demonstrate that HBO may effectively mitigate the COVID-19-induced inflammation.…”

Effects of Hyperbaric Oxygen Therapy on Long COVID: A Systematic Review

“…Following the removal of duplicate articles and exclusion of unrelated articles, based on their titles and abstracts, and articles that did not meet the selection criteria, 10 articles were ultimately included in the study. Of the ten selected articles, one was a case report [17], five were one-group pretest-post-test designed studies [18][19][20][21][22], one was a safety report for RCTs [23], and three were complete reports of RCTs [24][25][26].…”