Hyperbaric oxygen therapy improves neurocognitive functions and symptoms of post-COVID condition: randomized controlled trial

Abstract

Post-COVID-19 condition refers to a range of persisting physical, neurocognitive, and neuropsychological symptoms after SARS-CoV-2 infection. The mechanism can be related to brain tissue pathology caused by virus invasion or indirectly by neuroinflammation and hypercoagulability. This randomized, sham-control, double blind trial evaluated the effect of hyperbaric oxygen therapy (HBOT or HBO2 therapy) on post-COVID-19 patients with ongoing symptoms for at least 3 months after confirmed infection. Seventy-three patients were randomized to receive daily 40 session of HBOT (n = 37) or sham (n = 36). Follow-up assessments were performed at baseline and 1–3 weeks after the last treatment session. Following HBOT, there was a significant group-by-time interaction in global cognitive function, attention and executive function (d = 0.495, p = 0.038; d = 0.477, p = 0.04 and d = 0.463, p = 0.05 respectively). Significant improvement was also demonstrated in the energy domain (d = 0.522, p = 0.029), sleep (d = − 0.48, p = 0.042), psychiatric symptoms (d = 0.636, p = 0.008), and pain interference (d = 0.737, p = 0.001). Clinical outcomes were associated with significant improvement in brain MRI perfusion and microstructural changes in the supramarginal gyrus, left supplementary motor area, right insula, left frontal precentral gyrus, right middle frontal gyrus, and superior corona radiate. These results indicate that HBOT can induce neuroplasticity and improve cognitive, psychiatric, fatigue, sleep and pain symptoms of patients suffering from post-COVID-19 condition. HBOT’s beneficial effect may be attributed to increased brain perfusion and neuroplasticity in regions associated with cognitive and emotional roles.

Effects of hyperbaric oxygen therapy on functional and structural connectivity in post-COVID-19 condition patients: A randomized, sham-controlled trial

“…Post-COVID-19 condition is associated with long term psychiatric symptoms including depression, anxiety, and somatization ( Stefano, 2021 , Vanderlind et al, 2021 ). As shown in our previous publication, HBOT improved both depression and somatization symptoms in post-COVID-19 condition patients ( Zilberman-Itskovich et al, 2022 ). An association between COVID-19 related psychiatric symptoms and alternations in rsFC has been demonstrated in several studies ( Chen et al, 2021 , Fu et al, 2021 , Liu et al, 2021 , Sheynin et al, 2020 ).…”

“…The results of the cognitive tests and BSI-18 questionnaires are detailed in our previous publication ( Zilberman-Itskovich et al, 2022 ) and were used for correlation with the connectivity data. Briefly, following HBOT, there was a significant group-by-time interaction in global cognitive function, attention and executive function (d=0.495, p=0.038; d=0.477, p=0.04 and d=0.463, p=0.05 respectively).…”

“…This study is part of a comprehensive post-COVID-19 condition study. Detailed overview of the methodology and results of the clinical outcomes are provided in the study protocol and in ( Zilberman-Itskovich et al, 2022 ). The study was approved by SMC’s Institutional Review Board (IRB) (No.…”

“…We have recently shown in a prospective, randomized sham-controlled trial that hyperbaric oxygen therapy (HBOT) improves dysexecutive functions, psychiatric symptoms and fatigue in post-COVID-19 condition patients ( Zilberman-Itskovich et al, 2022 ). Clinical improvements were correlated with increased cerebral blood flow (CBF), increased gray-matter mean diffusivity (MD), and increased white-matter fractional anisotropy (FA) in frontal, parietal and limbic regions associated with cognitive and psychiatric roles.…”

Post Covid: Ein Überblick über Symptome, Risikofaktoren, Pathophysiologie und Therapieansätze

“…14% (95% 13% (95% 36% (95% KI 27-46) 19% (95% KI 10% (95% 23% (95% KI [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] kardiovaskuläres System Risikofaktoren für Post Covid…”